Emerging role of hepatocellular carcinoma among liver-related causes of deaths in HIV-infected patients: The French national Mortalité 2005 study

Salmon‐Céron, Dominique; Rosenthal, Éric; Lewden, Charlotte; Bouteloup, Vincent; May, Thierry; Burty, C.; Bonnet, Fabrice; Costagliola, Dominique; Jougla, Éric; Semaille, Caroline; Morlat, Philippe; Cacoub, Patrice; Chêne, Geneviève

doi:10.1016/j.jhep.2008.11.018

Cited by 106 publications

(68 citation statements)

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“…HCC has become a major problem in HIV/HCVcoinfected patients [29], as highlighted in the previous Mortalité 2005 study [30]. In this study, 12 patients died from HCC and the majority of cases (nine out of 12) were related to HCV infection.…”

Section: Discussionmentioning

confidence: 66%

“…In 2010, improved access to HCV care and the increased rate of sustained virological response may have counterbalanced such detrimental factors and accounted for the stabilization of liver-related mortality. Premature death of patients with severe chronic liver diseases during the first decade (1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005) may have positively impacted LRD mortality in 2010.HCC has become a major problem in HIV/HCVcoinfected patients [29], as highlighted in the previous Mortalité 2005 study [30]. In this study, 12 patients died from HCC and the majority of cases (nine out of 12) were related to HCV infection.…”

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confidence: 99%

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Liver‐related deaths in HIV‐infected patients between 1995 and 2010 in France: the Mortavic 2010 study in collaboration with the Agence Nationale de Recherche sur le SIDA (ANRS) EN 20 Mortalité 2010 survey

et al. 2014

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ObjectivesThe aim of this study was to describe the proportion of liver-related diseases (LRDs) as a cause of death in HIV-infected patients in France and to compare the results with data from our five previous surveys. MethodsIn 2010, 24 clinical wards prospectively recorded all deaths occurring in around 26 000 HIV-infected patients who were regularly followed up. Results were compared with those of previous cross-sectional surveys conducted since 1995 using the same design. ResultsAmong 230 reported deaths, 46 (20%) were related to AIDS and 30 (13%) to chronic liver diseases. Eighty per cent of patients who died from LRDs had chronic hepatitis C, 16.7% of them being coinfected with hepatitis B virus (HBV). Among patients who died from an LRD, excessive alcohol consumption was reported in 41%. At death, 80% of patients had undetectable HIV viral load and the median CD4 cell count was 349 cells/μL. The proportion of deaths and the mortality rate attributable to LRDs significantly increased between 1995 and 2005 from 1.5% to 16.7% and from 1.2‰ to 2.0‰, respectively, whereas they tended to decrease in 2010 to 13% and 1.1‰, respectively. Among liver-related causes of death, the proportion represented by hepatocellular carcinoma (HCC) dramatically increased from 5% in 1995 to 40% in 2010 (p = 0.019). ConclusionsThe proportion of LRDs among causes of death in HIV-infected patients seems recently to have reached a plateau after a rapid increase during the decade 1995−2005. LRDs remain a leading IntroductionAs a consequence of shared transmission routes, HIVinfected persons are at risk of other blood-borne and sexually transmitted infections. Hepatitis C virus (HCV) infection, which is predominantly transmitted parenterally, is common in this group. In northern countries, since the mid-1990s, several developments, such as the widespread use of combination antiretroviral therapy (cART) and better access to treatment for chronic hepatitis C, have contributed (1) to modifications of the natural history of chronic HCV infection in HIV-infected persons, and (2) to the emergence of liver-related diseases (LRDs) as a significant cause of mortality among coinfected individuals [1][2][3][4]. During the first decade following the advent of cART (1995−2005), the proportion of deaths attributable to LRDs in French HIV-infected patients has progressively increased and LRDs have become a leading cause of mortality [5][6][7][8]. This is likely to have been related to prolonged longevity as a result of decreasing AIDS-related mortality and longer exposure to chronic HCV infection. In parallel, large trials have demonstrated that HIV/HCV-coinfected patients may achieve a sustained virological response with combined treatment with pegylated interferon plus ribavirin, leading to histopathological improvement [9,10]. Continuing efforts to educate physicians and patients increased the access of HIV/HCV-coinfected patients to HCV treatment [11,12]. Finally, the eradication of HCV after therapy in HIV/HCV-coinfected patients is associate...

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Section: Discussionmentioning

confidence: 66%

mentioning

confidence: 99%

Liver‐related deaths in HIV‐infected patients between 1995 and 2010 in France: the Mortavic 2010 study in collaboration with the Agence Nationale de Recherche sur le SIDA (ANRS) EN 20 Mortalité 2010 survey

et al. 2014

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“…41 The use of nucleoside analogues, particularly with zidovudine and stavudine, is associated with hepatic steatosis. 42 HIV-positive patients presenting with HCC appear to be younger (52 versus 64 years, P < 0.001), to be more frequently symptomatic at presentation, to have multiple tumors or invasive disease, and to have advanced tumors in comparison with HIV-negative patients. 20,43 No data are available about the costeffectiveness of screening for HCC in HIV-positive patients with cirrhosis.…”

Section: Nonviral Etiologiesmentioning

confidence: 94%

Liver transplantation in human immunodeficiency virus-positive patients

et al. 2011

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“…Studies have shown that excessive consumption of alcohol appears to be a cofactor that increases mortality from liver disease in co-infected patients [40,47]. Most cases of liver associated mortality in co-infected patients are due to end-stage liver disease or hepato-cellular carcinomia [48].…”

Section: Route Of Transmissionmentioning

confidence: 99%

HIV Co-Infection with Hepatotropic Viruses and Mycobacterial Tuberculosis

BU¹

2013

J AIDS Clin Res

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Emerging role of hepatocellular carcinoma among liver-related causes of deaths in HIV-infected patients: The French national Mortalité 2005 study

Abstract: word count: 197Text word count: 3334 (abstract excluded)Figures: 2 Tables: 3 ABSTRACT: Background. Longer exposure to hepatitis C (HCV) or B virus (HBV) and the increased use of

Cited by 106 publications

References 35 publications

Liver‐related deaths in HIV‐infected patients between 1995 and 2010 in France: the Mortavic 2010 study in collaboration with the Agence Nationale de Recherche sur le SIDA (ANRS) EN 20 Mortalité 2010 survey

Liver‐related deaths in HIV‐infected patients between 1995 and 2010 in France: the Mortavic 2010 study in collaboration with the Agence Nationale de Recherche sur le SIDA (ANRS) EN 20 Mortalité 2010 survey

Liver transplantation in human immunodeficiency virus-positive patients

HIV Co-Infection with Hepatotropic Viruses and Mycobacterial Tuberculosis

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