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Low performance of ultrasound surveillance for the diagnosis of hepatocellular carcinoma in HIV-infected patients

Fecha de publicación:

Autores de IIS La Fe

Participantes ajenos a IIS La Fe

  • Merchante, N
  • Figueruela, B
  • Rodriguez-Fernandez, M
  • Rodriguez-Arrondo, F
  • Revollo, B
  • Ibarra, S
  • Galindo, MJ
  • Merino, E
  • Tellez, F
  • Garcia-Deltoro, M
  • Rivero-Juarez, A
  • Delgado-Fernandez, M
  • Rios-Villegas, MJ
  • Aguirrebengoa, K
  • Garcia, MA
  • Portu, J
  • Vera-Mendez, FJ
  • Villalobos, M
  • Minguer, C
  • De Los Santos, I
  • Lopez-Ruz, MA
  • Omar, M
  • Galera, C
  • Macias, J
  • Pineda, JA
  • GEHEP-002 Study Grp

Grupos

Abstract

Objective: To assess the performance of ultrasound surveillance for the diagnosis of hepatocellular carcinoma (HCC) in HIV-infected patients. Methods: The GEHEP-002 cohort recruits HCC cases diagnosed in HIV-infected patients from 32 centers across Spain. The proportion of 'ultrasound lack of detection', defined as HCC diagnosed within the first 3 months after a normal surveillance ultrasound, and the proportion of 'surveillance failure', defined as cases in which surveillance failed to detect HCC at early stage, were assessed. To assess the impact of HIV, a control population of 104 HCC cases diagnosed in hepatitis C virus-monoinfected patients during the study period was used. Results: A total of 186 (54%) out of 346 HCC cases in HIV-infected patients were diagnosed within an ultrasound surveillance program. Ultrasound lack of detection occurred in 16 (8.6%) of them. Ultrasound surveillance failure occurred in 107 (57%) out of 186 cases diagnosed by screening, whereas this occurred in 18 (29%) out of 62 diagnosed in the control group (P < 0.0001). HCC cases after ultrasound surveillance failure showed a lower frequency of undetectable HIV viral load at diagnosis. The probability of 1-year and 2-year survival after HCC diagnosis among those diagnosed by screening was 56 and 45% in HIV-infected patients, whereas it was 79 and 64% in HIV-negative patients (P = 0.038). Conclusion: The performance of ultrasound surveillance of HCC in HIV-infected patients is very poor and worse than that shown outside HIV infection. A HCC surveillance policy based on ultrasound examinations every 6 months might be insufficient in HIV-infected patients with cirrhosis.

Datos de la publicación

ISSN/ISSNe:
0269-9370, 1473-5571

AIDS  LIPPINCOTT WILLIAMS & WILKINS

Tipo:
Article
Páginas:
269-278
PubMed:
30325782
Factor de Impacto:
2,447 SCImago ℠
Cuartil:
Q1 SCImago ℠

Citas Recibidas en Web of Science: 11

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Keywords

  • abdominal ultrasound; hepatitis C virus; hepatocellular carcinoma; HIV; liver cirrhosis; surveillance

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