Risk of HCC With Hepatitis B Viremia Among HIV/HBV‐Coinfected Persons in North America
Background and Aims Chronic HBV is the predominant cause of HCC worldwide. Although HBV coinfection is common in HIV, the determinants of HCC in HIV/HBV coinfection are poorly characterized. We examined the predictors of HCC in a multicohort study of individuals coinfected with HIV/HBV. Approach and...
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| Veröffentlicht in: | Hepatology (Baltimore, Md.) Md.), 2021-09, Vol.74 (3), p.1190-1202 |
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| creator | Kim, H. Nina Newcomb, Craig W. Carbonari, Dena M. Roy, Jason A. Torgersen, Jessie Althoff, Keri N. Kitahata, Mari M. Reddy, K. Rajender Lim, Joseph K. Silverberg, Michael J. Mayor, Angel M. Horberg, Michael A. Cachay, Edward R. Kirk, Gregory D. Sun, Jing Hull, Mark Gill, M. John Sterling, Timothy R. Kostman, Jay R. Peters, Marion G. Moore, Richard D. Klein, Marina B. Lo Re, Vincent |
| description | Background and Aims
Chronic HBV is the predominant cause of HCC worldwide. Although HBV coinfection is common in HIV, the determinants of HCC in HIV/HBV coinfection are poorly characterized. We examined the predictors of HCC in a multicohort study of individuals coinfected with HIV/HBV.
Approach and Results
We included persons coinfected with HIV/HBV within 22 cohorts of the North American AIDS Cohort Collaboration on Research and Design (1995‐2016). First occurrence of HCC was verified by medical record review and/or cancer registry. We used multivariable Cox regression to determine adjusted HRs (aHRs [95% CIs]) of factors assessed at cohort entry (age, sex, race, body mass index), ever during observation (heavy alcohol use, HCV), or time‐updated (HIV RNA, CD4+ percentage, diabetes mellitus, HBV DNA). Among 8,354 individuals coinfected with HIV/HBV (median age, 43 years; 93% male; 52.4% non‐White), 115 HCC cases were diagnosed over 65,392 person‐years (incidence rate, 1.8 [95% CI, 1.5‐2.1] events/1,000 person‐years). Risk factors for HCC included age 40‐49 years (aHR, 1.97 [1.22‐3.17]), age ≥50 years (aHR, 2.55 [1.49‐4.35]), HCV coinfection (aHR, 1.61 [1.07‐2.40]), and heavy alcohol use (aHR, 1.52 [1.04‐2.23]), while time‐updated HIV RNA >500 copies/mL (aHR, 0.90 [0.56‐1.43]) and time‐updated CD4+ percentage 200 IU/mL (aHR, 2.22 [1.42‐3.47]) and was higher with each 1.0 log10 IU/mL increase in time‐updated HBV DNA (aHR, 1.18 [1.05‐1.34]). HBV suppression with HBV‐active antiretroviral therapy (ART) for ≥1 year significantly reduced HCC risk (aHR, 0.42 [0.24‐0.73]).
Conclusion
Individuals coinfected with HIV/HBV on ART with detectable HBV viremia remain at risk for HCC. To gain maximal benefit from ART for HCC prevention, sustained HBV suppression is necessary. |
| doi_str_mv | 10.1002/hep.31839 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2506509085</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2572539050</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3889-e6e7253a4e457d6d98ce4bb810f16e6d52c774479a4add3af40428c3be669e7d3</originalsourceid><addsrcrecordid>eNp10MFKxDAQBuAgiq6rB19AAl700N1p0zTNcbeoFURFdPVWsu1Uo9tmTbqINx_BZ_RJjK56EDwNgS8_Mz8hOyEMQoBoeI_zAQtTJldIL-SRCBjjsEp6EAkIZMjkBtl07gEAZByl62SDMZH6l-iR20vtHqmpaZ5l9EZ39zTHuep0px0d04m22GhFR41p72h-Mhnm48n761tmdFtj2WFFL9A60zqqW3pmrP8_atDqUm2RtVrNHG5_zz65Pjq8yvLg9Pz4JBudBiVLUxlggiLiTMUYc1EllUxLjKfTNIQ6TDCpeFQKEcdCqlhVFVN1DP6Ekk0xSSSKivXJ_jJ3bs3TAl1XNNqVOJupFs3CFRGHhIOElHu694c-mIVt_XZefW4hgYNXB0tVWuOcxbqYW90o-1KEUHzWXfi6i6-6vd39TlxMG6x-5U-_HgyX4FnP8OX_pCI_vFhGfgBuc4dC</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2572539050</pqid></control><display><type>article</type><title>Risk of HCC With Hepatitis B Viremia Among HIV/HBV‐Coinfected Persons in North America</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><source>EZB-FREE-00999 freely available EZB journals</source><creator>Kim, H. Nina ; Newcomb, Craig W. ; Carbonari, Dena M. ; Roy, Jason A. ; Torgersen, Jessie ; Althoff, Keri N. ; Kitahata, Mari M. ; Reddy, K. Rajender ; Lim, Joseph K. ; Silverberg, Michael J. ; Mayor, Angel M. ; Horberg, Michael A. ; Cachay, Edward R. ; Kirk, Gregory D. ; Sun, Jing ; Hull, Mark ; Gill, M. John ; Sterling, Timothy R. ; Kostman, Jay R. ; Peters, Marion G. ; Moore, Richard D. ; Klein, Marina B. ; Lo Re, Vincent</creator><creatorcontrib>Kim, H. Nina ; Newcomb, Craig W. ; Carbonari, Dena M. ; Roy, Jason A. ; Torgersen, Jessie ; Althoff, Keri N. ; Kitahata, Mari M. ; Reddy, K. Rajender ; Lim, Joseph K. ; Silverberg, Michael J. ; Mayor, Angel M. ; Horberg, Michael A. ; Cachay, Edward R. ; Kirk, Gregory D. ; Sun, Jing ; Hull, Mark ; Gill, M. John ; Sterling, Timothy R. ; Kostman, Jay R. ; Peters, Marion G. ; Moore, Richard D. ; Klein, Marina B. ; Lo Re, Vincent ; North American AIDS Cohort Collaboration on Research, Design of IeDEA ; for the North American AIDS Cohort Collaboration on Research, Design of IeDEA</creatorcontrib><description>Background and Aims
Chronic HBV is the predominant cause of HCC worldwide. Although HBV coinfection is common in HIV, the determinants of HCC in HIV/HBV coinfection are poorly characterized. We examined the predictors of HCC in a multicohort study of individuals coinfected with HIV/HBV.
Approach and Results
We included persons coinfected with HIV/HBV within 22 cohorts of the North American AIDS Cohort Collaboration on Research and Design (1995‐2016). First occurrence of HCC was verified by medical record review and/or cancer registry. We used multivariable Cox regression to determine adjusted HRs (aHRs [95% CIs]) of factors assessed at cohort entry (age, sex, race, body mass index), ever during observation (heavy alcohol use, HCV), or time‐updated (HIV RNA, CD4+ percentage, diabetes mellitus, HBV DNA). Among 8,354 individuals coinfected with HIV/HBV (median age, 43 years; 93% male; 52.4% non‐White), 115 HCC cases were diagnosed over 65,392 person‐years (incidence rate, 1.8 [95% CI, 1.5‐2.1] events/1,000 person‐years). Risk factors for HCC included age 40‐49 years (aHR, 1.97 [1.22‐3.17]), age ≥50 years (aHR, 2.55 [1.49‐4.35]), HCV coinfection (aHR, 1.61 [1.07‐2.40]), and heavy alcohol use (aHR, 1.52 [1.04‐2.23]), while time‐updated HIV RNA >500 copies/mL (aHR, 0.90 [0.56‐1.43]) and time‐updated CD4+ percentage <14% (aHR, 1.03 [0.56‐1.90]) were not. The risk of HCC was increased with time‐updated HBV DNA >200 IU/mL (aHR, 2.22 [1.42‐3.47]) and was higher with each 1.0 log10 IU/mL increase in time‐updated HBV DNA (aHR, 1.18 [1.05‐1.34]). HBV suppression with HBV‐active antiretroviral therapy (ART) for ≥1 year significantly reduced HCC risk (aHR, 0.42 [0.24‐0.73]).
Conclusion
Individuals coinfected with HIV/HBV on ART with detectable HBV viremia remain at risk for HCC. To gain maximal benefit from ART for HCC prevention, sustained HBV suppression is necessary.</description><identifier>ISSN: 0270-9139</identifier><identifier>EISSN: 1527-3350</identifier><identifier>DOI: 10.1002/hep.31839</identifier><identifier>PMID: 33780007</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Adult ; Age Factors ; Alcohol use ; Alcoholism - epidemiology ; Antiretroviral therapy ; Body mass index ; Carcinoma, Hepatocellular - epidemiology ; CD4 antigen ; Coinfection ; Deoxyribonucleic acid ; Diabetes mellitus ; DNA ; Female ; Hepatitis B ; Hepatitis B, Chronic - epidemiology ; Hepatitis C, Chronic - epidemiology ; Hepatology ; HIV ; HIV Infections - epidemiology ; Human immunodeficiency virus ; Humans ; Liver Neoplasms - epidemiology ; Male ; Middle Aged ; Multivariate Analysis ; North America ; Proportional Hazards Models ; Risk Assessment ; Risk Factors ; Viremia ; Viremia - epidemiology</subject><ispartof>Hepatology (Baltimore, Md.), 2021-09, Vol.74 (3), p.1190-1202</ispartof><rights>2021 by the American Association for the Study of Liver Diseases.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3889-e6e7253a4e457d6d98ce4bb810f16e6d52c774479a4add3af40428c3be669e7d3</citedby><cites>FETCH-LOGICAL-c3889-e6e7253a4e457d6d98ce4bb810f16e6d52c774479a4add3af40428c3be669e7d3</cites><orcidid>0000-0001-6710-9666 ; 0000-0003-3741-0962 ; 0000-0001-7955-0600</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fhep.31839$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fhep.31839$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33780007$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kim, H. Nina</creatorcontrib><creatorcontrib>Newcomb, Craig W.</creatorcontrib><creatorcontrib>Carbonari, Dena M.</creatorcontrib><creatorcontrib>Roy, Jason A.</creatorcontrib><creatorcontrib>Torgersen, Jessie</creatorcontrib><creatorcontrib>Althoff, Keri N.</creatorcontrib><creatorcontrib>Kitahata, Mari M.</creatorcontrib><creatorcontrib>Reddy, K. Rajender</creatorcontrib><creatorcontrib>Lim, Joseph K.</creatorcontrib><creatorcontrib>Silverberg, Michael J.</creatorcontrib><creatorcontrib>Mayor, Angel M.</creatorcontrib><creatorcontrib>Horberg, Michael A.</creatorcontrib><creatorcontrib>Cachay, Edward R.</creatorcontrib><creatorcontrib>Kirk, Gregory D.</creatorcontrib><creatorcontrib>Sun, Jing</creatorcontrib><creatorcontrib>Hull, Mark</creatorcontrib><creatorcontrib>Gill, M. John</creatorcontrib><creatorcontrib>Sterling, Timothy R.</creatorcontrib><creatorcontrib>Kostman, Jay R.</creatorcontrib><creatorcontrib>Peters, Marion G.</creatorcontrib><creatorcontrib>Moore, Richard D.</creatorcontrib><creatorcontrib>Klein, Marina B.</creatorcontrib><creatorcontrib>Lo Re, Vincent</creatorcontrib><creatorcontrib>North American AIDS Cohort Collaboration on Research, Design of IeDEA</creatorcontrib><creatorcontrib>for the North American AIDS Cohort Collaboration on Research, Design of IeDEA</creatorcontrib><title>Risk of HCC With Hepatitis B Viremia Among HIV/HBV‐Coinfected Persons in North America</title><title>Hepatology (Baltimore, Md.)</title><addtitle>Hepatology</addtitle><description>Background and Aims
Chronic HBV is the predominant cause of HCC worldwide. Although HBV coinfection is common in HIV, the determinants of HCC in HIV/HBV coinfection are poorly characterized. We examined the predictors of HCC in a multicohort study of individuals coinfected with HIV/HBV.
Approach and Results
We included persons coinfected with HIV/HBV within 22 cohorts of the North American AIDS Cohort Collaboration on Research and Design (1995‐2016). First occurrence of HCC was verified by medical record review and/or cancer registry. We used multivariable Cox regression to determine adjusted HRs (aHRs [95% CIs]) of factors assessed at cohort entry (age, sex, race, body mass index), ever during observation (heavy alcohol use, HCV), or time‐updated (HIV RNA, CD4+ percentage, diabetes mellitus, HBV DNA). Among 8,354 individuals coinfected with HIV/HBV (median age, 43 years; 93% male; 52.4% non‐White), 115 HCC cases were diagnosed over 65,392 person‐years (incidence rate, 1.8 [95% CI, 1.5‐2.1] events/1,000 person‐years). Risk factors for HCC included age 40‐49 years (aHR, 1.97 [1.22‐3.17]), age ≥50 years (aHR, 2.55 [1.49‐4.35]), HCV coinfection (aHR, 1.61 [1.07‐2.40]), and heavy alcohol use (aHR, 1.52 [1.04‐2.23]), while time‐updated HIV RNA >500 copies/mL (aHR, 0.90 [0.56‐1.43]) and time‐updated CD4+ percentage <14% (aHR, 1.03 [0.56‐1.90]) were not. The risk of HCC was increased with time‐updated HBV DNA >200 IU/mL (aHR, 2.22 [1.42‐3.47]) and was higher with each 1.0 log10 IU/mL increase in time‐updated HBV DNA (aHR, 1.18 [1.05‐1.34]). HBV suppression with HBV‐active antiretroviral therapy (ART) for ≥1 year significantly reduced HCC risk (aHR, 0.42 [0.24‐0.73]).
Conclusion
Individuals coinfected with HIV/HBV on ART with detectable HBV viremia remain at risk for HCC. To gain maximal benefit from ART for HCC prevention, sustained HBV suppression is necessary.</description><subject>Adult</subject><subject>Age Factors</subject><subject>Alcohol use</subject><subject>Alcoholism - epidemiology</subject><subject>Antiretroviral therapy</subject><subject>Body mass index</subject><subject>Carcinoma, Hepatocellular - epidemiology</subject><subject>CD4 antigen</subject><subject>Coinfection</subject><subject>Deoxyribonucleic acid</subject><subject>Diabetes mellitus</subject><subject>DNA</subject><subject>Female</subject><subject>Hepatitis B</subject><subject>Hepatitis B, Chronic - epidemiology</subject><subject>Hepatitis C, Chronic - epidemiology</subject><subject>Hepatology</subject><subject>HIV</subject><subject>HIV Infections - epidemiology</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Liver Neoplasms - epidemiology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>North America</subject><subject>Proportional Hazards Models</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Viremia</subject><subject>Viremia - epidemiology</subject><issn>0270-9139</issn><issn>1527-3350</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp10MFKxDAQBuAgiq6rB19AAl700N1p0zTNcbeoFURFdPVWsu1Uo9tmTbqINx_BZ_RJjK56EDwNgS8_Mz8hOyEMQoBoeI_zAQtTJldIL-SRCBjjsEp6EAkIZMjkBtl07gEAZByl62SDMZH6l-iR20vtHqmpaZ5l9EZ39zTHuep0px0d04m22GhFR41p72h-Mhnm48n761tmdFtj2WFFL9A60zqqW3pmrP8_atDqUm2RtVrNHG5_zz65Pjq8yvLg9Pz4JBudBiVLUxlggiLiTMUYc1EllUxLjKfTNIQ6TDCpeFQKEcdCqlhVFVN1DP6Ekk0xSSSKivXJ_jJ3bs3TAl1XNNqVOJupFs3CFRGHhIOElHu694c-mIVt_XZefW4hgYNXB0tVWuOcxbqYW90o-1KEUHzWXfi6i6-6vd39TlxMG6x-5U-_HgyX4FnP8OX_pCI_vFhGfgBuc4dC</recordid><startdate>202109</startdate><enddate>202109</enddate><creator>Kim, H. Nina</creator><creator>Newcomb, Craig W.</creator><creator>Carbonari, Dena M.</creator><creator>Roy, Jason A.</creator><creator>Torgersen, Jessie</creator><creator>Althoff, Keri N.</creator><creator>Kitahata, Mari M.</creator><creator>Reddy, K. Rajender</creator><creator>Lim, Joseph K.</creator><creator>Silverberg, Michael J.</creator><creator>Mayor, Angel M.</creator><creator>Horberg, Michael A.</creator><creator>Cachay, Edward R.</creator><creator>Kirk, Gregory D.</creator><creator>Sun, Jing</creator><creator>Hull, Mark</creator><creator>Gill, M. John</creator><creator>Sterling, Timothy R.</creator><creator>Kostman, Jay R.</creator><creator>Peters, Marion G.</creator><creator>Moore, Richard D.</creator><creator>Klein, Marina B.</creator><creator>Lo Re, Vincent</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TM</scope><scope>7TO</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-6710-9666</orcidid><orcidid>https://orcid.org/0000-0003-3741-0962</orcidid><orcidid>https://orcid.org/0000-0001-7955-0600</orcidid></search><sort><creationdate>202109</creationdate><title>Risk of HCC With Hepatitis B Viremia Among HIV/HBV‐Coinfected Persons in North America</title><author>Kim, H. Nina ; Newcomb, Craig W. ; Carbonari, Dena M. ; Roy, Jason A. ; Torgersen, Jessie ; Althoff, Keri N. ; Kitahata, Mari M. ; Reddy, K. Rajender ; Lim, Joseph K. ; Silverberg, Michael J. ; Mayor, Angel M. ; Horberg, Michael A. ; Cachay, Edward R. ; Kirk, Gregory D. ; Sun, Jing ; Hull, Mark ; Gill, M. John ; Sterling, Timothy R. ; Kostman, Jay R. ; Peters, Marion G. ; Moore, Richard D. ; Klein, Marina B. ; Lo Re, Vincent</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3889-e6e7253a4e457d6d98ce4bb810f16e6d52c774479a4add3af40428c3be669e7d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Age Factors</topic><topic>Alcohol use</topic><topic>Alcoholism - epidemiology</topic><topic>Antiretroviral therapy</topic><topic>Body mass index</topic><topic>Carcinoma, Hepatocellular - epidemiology</topic><topic>CD4 antigen</topic><topic>Coinfection</topic><topic>Deoxyribonucleic acid</topic><topic>Diabetes mellitus</topic><topic>DNA</topic><topic>Female</topic><topic>Hepatitis B</topic><topic>Hepatitis B, Chronic - epidemiology</topic><topic>Hepatitis C, Chronic - epidemiology</topic><topic>Hepatology</topic><topic>HIV</topic><topic>HIV Infections - epidemiology</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Liver Neoplasms - epidemiology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>North America</topic><topic>Proportional Hazards Models</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Viremia</topic><topic>Viremia - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kim, H. Nina</creatorcontrib><creatorcontrib>Newcomb, Craig W.</creatorcontrib><creatorcontrib>Carbonari, Dena M.</creatorcontrib><creatorcontrib>Roy, Jason A.</creatorcontrib><creatorcontrib>Torgersen, Jessie</creatorcontrib><creatorcontrib>Althoff, Keri N.</creatorcontrib><creatorcontrib>Kitahata, Mari M.</creatorcontrib><creatorcontrib>Reddy, K. Rajender</creatorcontrib><creatorcontrib>Lim, Joseph K.</creatorcontrib><creatorcontrib>Silverberg, Michael J.</creatorcontrib><creatorcontrib>Mayor, Angel M.</creatorcontrib><creatorcontrib>Horberg, Michael A.</creatorcontrib><creatorcontrib>Cachay, Edward R.</creatorcontrib><creatorcontrib>Kirk, Gregory D.</creatorcontrib><creatorcontrib>Sun, Jing</creatorcontrib><creatorcontrib>Hull, Mark</creatorcontrib><creatorcontrib>Gill, M. John</creatorcontrib><creatorcontrib>Sterling, Timothy R.</creatorcontrib><creatorcontrib>Kostman, Jay R.</creatorcontrib><creatorcontrib>Peters, Marion G.</creatorcontrib><creatorcontrib>Moore, Richard D.</creatorcontrib><creatorcontrib>Klein, Marina B.</creatorcontrib><creatorcontrib>Lo Re, Vincent</creatorcontrib><creatorcontrib>North American AIDS Cohort Collaboration on Research, Design of IeDEA</creatorcontrib><creatorcontrib>for the North American AIDS Cohort Collaboration on Research, Design of IeDEA</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Hepatology (Baltimore, Md.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kim, H. Nina</au><au>Newcomb, Craig W.</au><au>Carbonari, Dena M.</au><au>Roy, Jason A.</au><au>Torgersen, Jessie</au><au>Althoff, Keri N.</au><au>Kitahata, Mari M.</au><au>Reddy, K. Rajender</au><au>Lim, Joseph K.</au><au>Silverberg, Michael J.</au><au>Mayor, Angel M.</au><au>Horberg, Michael A.</au><au>Cachay, Edward R.</au><au>Kirk, Gregory D.</au><au>Sun, Jing</au><au>Hull, Mark</au><au>Gill, M. John</au><au>Sterling, Timothy R.</au><au>Kostman, Jay R.</au><au>Peters, Marion G.</au><au>Moore, Richard D.</au><au>Klein, Marina B.</au><au>Lo Re, Vincent</au><aucorp>North American AIDS Cohort Collaboration on Research, Design of IeDEA</aucorp><aucorp>for the North American AIDS Cohort Collaboration on Research, Design of IeDEA</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk of HCC With Hepatitis B Viremia Among HIV/HBV‐Coinfected Persons in North America</atitle><jtitle>Hepatology (Baltimore, Md.)</jtitle><addtitle>Hepatology</addtitle><date>2021-09</date><risdate>2021</risdate><volume>74</volume><issue>3</issue><spage>1190</spage><epage>1202</epage><pages>1190-1202</pages><issn>0270-9139</issn><eissn>1527-3350</eissn><abstract>Background and Aims
Chronic HBV is the predominant cause of HCC worldwide. Although HBV coinfection is common in HIV, the determinants of HCC in HIV/HBV coinfection are poorly characterized. We examined the predictors of HCC in a multicohort study of individuals coinfected with HIV/HBV.
Approach and Results
We included persons coinfected with HIV/HBV within 22 cohorts of the North American AIDS Cohort Collaboration on Research and Design (1995‐2016). First occurrence of HCC was verified by medical record review and/or cancer registry. We used multivariable Cox regression to determine adjusted HRs (aHRs [95% CIs]) of factors assessed at cohort entry (age, sex, race, body mass index), ever during observation (heavy alcohol use, HCV), or time‐updated (HIV RNA, CD4+ percentage, diabetes mellitus, HBV DNA). Among 8,354 individuals coinfected with HIV/HBV (median age, 43 years; 93% male; 52.4% non‐White), 115 HCC cases were diagnosed over 65,392 person‐years (incidence rate, 1.8 [95% CI, 1.5‐2.1] events/1,000 person‐years). Risk factors for HCC included age 40‐49 years (aHR, 1.97 [1.22‐3.17]), age ≥50 years (aHR, 2.55 [1.49‐4.35]), HCV coinfection (aHR, 1.61 [1.07‐2.40]), and heavy alcohol use (aHR, 1.52 [1.04‐2.23]), while time‐updated HIV RNA >500 copies/mL (aHR, 0.90 [0.56‐1.43]) and time‐updated CD4+ percentage <14% (aHR, 1.03 [0.56‐1.90]) were not. The risk of HCC was increased with time‐updated HBV DNA >200 IU/mL (aHR, 2.22 [1.42‐3.47]) and was higher with each 1.0 log10 IU/mL increase in time‐updated HBV DNA (aHR, 1.18 [1.05‐1.34]). HBV suppression with HBV‐active antiretroviral therapy (ART) for ≥1 year significantly reduced HCC risk (aHR, 0.42 [0.24‐0.73]).
Conclusion
Individuals coinfected with HIV/HBV on ART with detectable HBV viremia remain at risk for HCC. To gain maximal benefit from ART for HCC prevention, sustained HBV suppression is necessary.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>33780007</pmid><doi>10.1002/hep.31839</doi><tpages>13</tpages><orcidid>https://orcid.org/0000-0001-6710-9666</orcidid><orcidid>https://orcid.org/0000-0003-3741-0962</orcidid><orcidid>https://orcid.org/0000-0001-7955-0600</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0270-9139 |
| ispartof | Hepatology (Baltimore, Md.), 2021-09, Vol.74 (3), p.1190-1202 |
| issn | 0270-9139 1527-3350 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2506509085 |
| source | MEDLINE; Access via Wiley Online Library; EZB-FREE-00999 freely available EZB journals |
| subjects | Adult Age Factors Alcohol use Alcoholism - epidemiology Antiretroviral therapy Body mass index Carcinoma, Hepatocellular - epidemiology CD4 antigen Coinfection Deoxyribonucleic acid Diabetes mellitus DNA Female Hepatitis B Hepatitis B, Chronic - epidemiology Hepatitis C, Chronic - epidemiology Hepatology HIV HIV Infections - epidemiology Human immunodeficiency virus Humans Liver Neoplasms - epidemiology Male Middle Aged Multivariate Analysis North America Proportional Hazards Models Risk Assessment Risk Factors Viremia Viremia - epidemiology |
| title | Risk of HCC With Hepatitis B Viremia Among HIV/HBV‐Coinfected Persons in North America |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-23T10%3A51%3A14IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Risk%20of%20HCC%20With%20Hepatitis%20B%20Viremia%20Among%20HIV/HBV%E2%80%90Coinfected%20Persons%20in%20North%20America&rft.jtitle=Hepatology%20(Baltimore,%20Md.)&rft.au=Kim,%20H.%20Nina&rft.aucorp=North%20American%20AIDS%20Cohort%20Collaboration%20on%20Research,%20Design%20of%20IeDEA&rft.date=2021-09&rft.volume=74&rft.issue=3&rft.spage=1190&rft.epage=1202&rft.pages=1190-1202&rft.issn=0270-9139&rft.eissn=1527-3350&rft_id=info:doi/10.1002/hep.31839&rft_dat=%3Cproquest_cross%3E2572539050%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2572539050&rft_id=info:pmid/33780007&rfr_iscdi=true |