Systemic Inflammatory Response Is a Prognostic Marker in HIV-Infected Patients with Hepatocellular Carcinoma

Abstract

Background: Hepatocellular carcinoma (HCC) is increasingly prevalent in people living with HIV. Systemic inflammation is a prognostic factor requiring validation in HIV-associated HCC. Aims: Using a multi-centre database of consecutive HCC cases, we investigated the prognostic role of a panel of inflammatory markers, including neutrophil to lymphocyte ratio (NLR), using univariate and multivariate survival analyses. Results: Fifty-nine patients with HIV-associated HCC secondary to hepatitis C (69%) or B virus infection (32%) were identified. The median survival was 22 months. A raised NLR independently predicted patients' survival and was correlated with advanced Barcelona Clinic Liver Cancer stage (p = 0.003) and poor performance status (p < 0.001) but not with HIV RNA or CD4 counts. Conclusion: Systemic inflammation, as measured by NLR, is a prognostic determinant associated with adverse pathological features of malignancy, but not coexisting HIV infection, suggesting a tumour-promoting role of the innate immune response that warrants further investigation in mechanistic studies.

Prognostic role of inflammatory biomarkers in HIV‐infected patients with a first diagnosis of hepatocellular carcinoma: A single‐center study

“…To the best of our knowledge, only one previous published study analyzed the impact of serum inflammatory biomarkers in terms of OS in people living with HIV diagnosed with HCC . Similarly to Pinato et al results, we did not evidence any prognostic role for albumin‐based scores. There are no previous data regarding the impact of PNI in HIV‐infected people with HCC.…”

“…The same inflammatory biomarkers have been associated with an increased risk of death in HIV‐infected subjects with solid cancer and hematologic malignancies . To the best of our knowledge, only one study evaluated the prognostic role of these inflammation‐based indices in HIV‐living people with HCC …”

The albumin‐bilirubin grade uncovers the prognostic relationship between hepatic reserve and immune dysfunction in HIV‐associated hepatocellular carcinoma

“…Initial studies comparing survival outcomes in series of HCC patients matched by HIV status had originally reported a significantly shorter survival in HIV‐infected patients, with higher intra and extra‐hepatic disease burden and poor liver function emerging as adverse prognostic factors . However, with the diffusion of standardised screening and treatment strategies including adoption of the BCLC staging algorithm from the early 2000s, HIV status vanished as an independent prognostic determinant in subsequent studies, where optimal control of HIV infection no longer precluded access to active anticancer treatment in the cART era …”

Measurement of Serum and Hepatic Eicosanoids by Liquid Chromatography Tandem-Mass Spectrometry (LC-MS/MS) in a Mouse Model of Hepatocellular Carcinoma (HCC) with Delivery of c-Met and Activated β-Catenin by Hepatocyte Hydrodynamic Injection

“…Chronic inflammation has a role in the development of hepatocellular carcinoma (HCC) in humans, but the underlying mechanisms remain unclear [ 23 ]. Eicosanoids are produced form arachidic acid in the hepatocyte, and when secreted into the blood they act as signaling molecules.…”