Document Detail


HIV-induced immune deficiency is associated with a higher risk of hepatocarcinoma, ANRS CO3 Aquitaine Cohort, France, 1998-2008.
MedLine Citation:
PMID:  21354449     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND & AIMS: HIV and viral hepatitis co-infected patients are at high risk for hepatocarcinoma. The contribution of immunodeficiency is not well documented. We aimed at estimating the relationship between the occurrence of hepatocarcinoma and both types of measures of immunodeficiency, current and cumulative (time below a given threshold), to assess their independent effects.
METHODS: HIV-infected adults included in the ANRS CO3 Aquitaine Cohort with no history of cancer, ≥ 3 months of follow-up between 1998 and 2008, ≥ 1 CD4+ cell count (CD4+), and documented hepatitis virus status were eligible. Extended Cox proportional hazards models with delayed entry were used to estimate the risk of hepatocarcinoma. Exposure to a CD4+ < 350 or <500 cells/mm(3) (current and cumulative duration) was time-updated. Hepatitis B or C virus co-infection and gender were fixed-effect variables.
RESULTS: Sixteen cases of hepatocarcinoma were diagnosed among the 2864 eligible patients, the incidence rate was 0.78 case/1000 person-years (95% Confidence Interval [CI]: 0.40-1.16). Current CD4+ < 350 or < 500 was independently associated with a higher risk of hepatocarcinoma (Hazard Ratio [HR]: 5.0, CI 1.5-16.8, p = 0.009 and HR = 10.3, CI 1.3-82.8, p = 0.029, respectively). The occurrence of hepatocarcinoma was independent of the cumulative exposure to a CD4+ < 350 or < 500 (p = 0.38 or p = 0.80, respectively).
CONCLUSIONS: Presenting with CD4+ < 500 was associated with a higher risk of hepatocarcinoma, whereas the cumulative duration with immunodeficiency was not. These results suggest that moving CD4+ count above 500 following antiretroviral therapy initiation is associated with a decreased risk of hepatocarcinoma, regardless of the duration of HIV-induced immunodeficiency.
Authors:
Mathias Bruyand; François Dabis; Marie-Anne Vandenhende; Estibaliz Lazaro; Didier Neau; Olivier Leleux; Stéphane Geffard; Philippe Morlat; Geneviève Chêne; Fabrice Bonnet
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-02-25
Journal Detail:
Title:  Journal of hepatology     Volume:  55     ISSN:  1600-0641     ISO Abbreviation:  J. Hepatol.     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-10-19     Completed Date:  2012-03-06     Revised Date:  2012-08-24    
Medline Journal Info:
Nlm Unique ID:  8503886     Medline TA:  J Hepatol     Country:  England    
Other Details:
Languages:  eng     Pagination:  1058-62     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
Affiliation:
INSERM U 897, Bordeaux School of Public Health (ISPED), Université Bordeaux Segalen, Bordeaux, France. mathias.bruyand@isped.u-bordeaux2.fr
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MeSH Terms
Descriptor/Qualifier:
Adult
Anti-Retroviral Agents / therapeutic use
CD4 Lymphocyte Count*
Carcinoma, Hepatocellular / epidemiology*,  immunology
Coinfection / complications
Female
France / epidemiology
HIV Infections / complications*,  drug therapy,  immunology*
Hepacivirus
Hepatitis B / complications
Hepatitis B virus
Hepatitis C / complications
Humans
Incidence
Liver Neoplasms / epidemiology*,  immunology
Male
Middle Aged
Proportional Hazards Models
Risk Factors
Time Factors
Chemical
Reg. No./Substance:
0/Anti-Retroviral Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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