Loco-Regional Treatments for Hepatocellular Carcinoma in People Living with HIV

Abstract

Hepatocellular carcinoma (HCC) accounts for approximately 75–90% of primary liver cancers and is the sixth most common cancer and the third leading cause of cancer-related deaths worldwide. In the HIV-positive population, the risk of HCC is approximately four times higher than in the general population, with higher cancer-specific mortality than in HIV-negative patients. In most cases, HCC diagnosis is made in patients younger than the HIV-negative population and in the intermediate-advanced stage, thus limiting the therapeutic possibilities. Treatment choice in HIV-positive patients with HCC is subject to cancer staging, liver function and health status, as for HIV-negative and non-HIV-negative HCC patients. There are relatively few studies on the efficacy and safety in HIV-positive patients to date in loco-regional treatments for HCC. So far, literature shows that curative treatments such as radiofrequency ablation (RFA) have no significant differences in overall survival between HIV-positive and HIV-negative patients, as opposed to palliative treatments such as TACE, where there is a significant difference in overall survival. Although it can be assumed that the most recently discovered loco-regional therapies are applicable to HIV-positive patients with HCC in the same way as HIV-negative patients, further studies are needed to confirm this hypothesis. The purpose of our review is to evaluate these treatments, their efficacy, effectiveness, safety and their applicability to HIV-positive patients.

HIV Infection Diagnosis in a Late Presenter Patient during a Severe Imported Falciparum Malaria: A Challenging

“…For the patient we described, HIV infection diagnosis was concomitant to severe opportunistic infections, such as bacteremia and candidemia, although successfully treated with appropriate therapies. Malaria and HIV coinfection led to a deeper immunosuppressive condition which often poorly affect the outcome of both the diseases [20], [21], also compromising treatment success of other occurring infections [22], [23]. Moreover, it is also fundamental to screen these patients for other infections, such as HBV [24] and HCV [20], sharing both the ways of transmission and epidemiological characteristics.…”

Thyroid Diseases and Thyroid Asymptomatic Dysfunction in People Living With HIV

“…In the post-ART era, there was a decrease in the incidence of AIDS-defining cancers (ADCs) and a contemporary increase in others such as melanoma, anal, cervix, liver, breast and prostate cancers [ 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 ]. However, PLWH are frequently diagnosed with advanced-stage Non AIDS-defining cancers (NADCs) and experience a more aggressive clinical course, poorer outcome, higher rate of relapse and worse treatment response than the general population [ 33 ].…”

Diagnosis, Treatment, and Prevention of HIV Infection among Detainees: A Review of the Literature

“…STIs are often difficult to diagnose because of the lack of symptoms; however, they can lead to adverse outcomes such as infertility or, in the long-term, cancer [ 39 , 40 , 41 , 42 , 43 , 44 ]. The prevalence of STIs among inmates is significantly higher than the general population [ 45 , 46 ].…”