Outcome of TACE treatment in HIV infected patients with hepatocellular carcinoma

Abstract The surgical treatment and transcatheter arterial chemoembolization (TACE) rate of human immunodeficiency virus (HIV)-infected hepatocellular carcinoma (HCC) patients is relatively low in West China. For various reasons, most patients do not receive timely surgical treatment. Upon transfer...

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Autores principales:	Lingxiang Kong, Guo Wei, Tao Lv, Li Jiang, Jian Yang, Yong Zhao, Jiayin Yang
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/77c967e597ef46539a7503b7bd2f0f91
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spelling	oai:doaj.org-article:77c967e597ef46539a7503b7bd2f0f912021-12-02T14:01:21ZOutcome of TACE treatment in HIV infected patients with hepatocellular carcinoma10.1038/s41598-020-80311-32045-2322https://doaj.org/article/77c967e597ef46539a7503b7bd2f0f912021-01-01T00:00:00Zhttps://doi.org/10.1038/s41598-020-80311-3https://doaj.org/toc/2045-2322Abstract The surgical treatment and transcatheter arterial chemoembolization (TACE) rate of human immunodeficiency virus (HIV)-infected hepatocellular carcinoma (HCC) patients is relatively low in West China. For various reasons, most patients do not receive timely surgical treatment. Upon transfer to an infectious disease centralized hospital, they were already classified in the Barcelona Clinic Liver Cancer (BCLC)-B stage. A total of 2249 BCLC-B HCC patients were analyzed. The eligible population was divided into three groups for analysis of survival and prognostic factors; These were 21 HIV infected (HIV+) HCC patients treated with TACE (TACE+), 1293 non-HIV-infected (HIV−) HCC patients treated with TACE, and 150 HIV− HCC patients who only receive medication (TACE−) as a second control group. After 1:2 matching, 1- and 2-year survival of HIV+ TACE+ and HIV− TACE+ groups was 64.3% and 76.5% (P = 0.453) and 45.5% vs. 50.0% (P = 0.790) respectively. We also compared one and two-year survival between HIV+ TACE+ and HIV− TACE−. One-year overall survival was 64.3% vs. 45.7% (P = 0.097) and 2-year survival was 45.5% vs. 7.1% (P = 0.004). Multivariate analysis showed that the most important prognostic factors for survival were serum alpha-fetoprotein (AFP) and Child–Pugh score and tumor size, while HIV status had no significant effect on prognosis statistically. CD4 levels below 200 may increase the risk of opportunistic infection after surgery, but after anti-infection and systematic supportive therapy, it has no effect on survival. HIV+ patients should have the same treatment opportunities as HIV− patients. If the patient's immune status permits, we suggest that early TACE treatment should be administered to BCLC-B HCC patients, regardless of HIV infection.Lingxiang KongGuo WeiTao LvLi JiangJian YangYong ZhaoJiayin YangNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Lingxiang Kong Guo Wei Tao Lv Li Jiang Jian Yang Yong Zhao Jiayin Yang Outcome of TACE treatment in HIV infected patients with hepatocellular carcinoma
description	Abstract The surgical treatment and transcatheter arterial chemoembolization (TACE) rate of human immunodeficiency virus (HIV)-infected hepatocellular carcinoma (HCC) patients is relatively low in West China. For various reasons, most patients do not receive timely surgical treatment. Upon transfer to an infectious disease centralized hospital, they were already classified in the Barcelona Clinic Liver Cancer (BCLC)-B stage. A total of 2249 BCLC-B HCC patients were analyzed. The eligible population was divided into three groups for analysis of survival and prognostic factors; These were 21 HIV infected (HIV+) HCC patients treated with TACE (TACE+), 1293 non-HIV-infected (HIV−) HCC patients treated with TACE, and 150 HIV− HCC patients who only receive medication (TACE−) as a second control group. After 1:2 matching, 1- and 2-year survival of HIV+ TACE+ and HIV− TACE+ groups was 64.3% and 76.5% (P = 0.453) and 45.5% vs. 50.0% (P = 0.790) respectively. We also compared one and two-year survival between HIV+ TACE+ and HIV− TACE−. One-year overall survival was 64.3% vs. 45.7% (P = 0.097) and 2-year survival was 45.5% vs. 7.1% (P = 0.004). Multivariate analysis showed that the most important prognostic factors for survival were serum alpha-fetoprotein (AFP) and Child–Pugh score and tumor size, while HIV status had no significant effect on prognosis statistically. CD4 levels below 200 may increase the risk of opportunistic infection after surgery, but after anti-infection and systematic supportive therapy, it has no effect on survival. HIV+ patients should have the same treatment opportunities as HIV− patients. If the patient's immune status permits, we suggest that early TACE treatment should be administered to BCLC-B HCC patients, regardless of HIV infection.
format	article
author	Lingxiang Kong Guo Wei Tao Lv Li Jiang Jian Yang Yong Zhao Jiayin Yang
author_facet	Lingxiang Kong Guo Wei Tao Lv Li Jiang Jian Yang Yong Zhao Jiayin Yang
author_sort	Lingxiang Kong
title	Outcome of TACE treatment in HIV infected patients with hepatocellular carcinoma
title_short	Outcome of TACE treatment in HIV infected patients with hepatocellular carcinoma
title_full	Outcome of TACE treatment in HIV infected patients with hepatocellular carcinoma
title_fullStr	Outcome of TACE treatment in HIV infected patients with hepatocellular carcinoma
title_full_unstemmed	Outcome of TACE treatment in HIV infected patients with hepatocellular carcinoma
title_sort	outcome of tace treatment in hiv infected patients with hepatocellular carcinoma
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/77c967e597ef46539a7503b7bd2f0f91
work_keys_str_mv	AT lingxiangkong outcomeoftacetreatmentinhivinfectedpatientswithhepatocellularcarcinoma AT guowei outcomeoftacetreatmentinhivinfectedpatientswithhepatocellularcarcinoma AT taolv outcomeoftacetreatmentinhivinfectedpatientswithhepatocellularcarcinoma AT lijiang outcomeoftacetreatmentinhivinfectedpatientswithhepatocellularcarcinoma AT jianyang outcomeoftacetreatmentinhivinfectedpatientswithhepatocellularcarcinoma AT yongzhao outcomeoftacetreatmentinhivinfectedpatientswithhepatocellularcarcinoma AT jiayinyang outcomeoftacetreatmentinhivinfectedpatientswithhepatocellularcarcinoma
_version_	1718392206863106048

Outcome of TACE treatment in HIV infected patients with hepatocellular carcinoma

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