Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026
Risk of Hepatocellular Carcinoma After Direct-Acting Antiviral Treatment for Hepatitis C Virus Infection in People With HIV.
СтатьяПоддержка исследования: вне правительства СШАПоддержка NIH: внешняя программаНазвание и аннотация: Перевод в очереди
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van Santen Daniela K, Chalouni Mathieu, Berenguer Juan, Jarrin Inmaculada, Miró José M, Klein Marina B, Young Jim, Torgersen Jessie, Rentsch Christopher T, Gill Michael J, Epstein Rachel L, Nunes David, Surial Bernard, Rauch Andri, Touloumi Giota, Papadopoulos Antonios, Wittkop Linda, Gilbert Camille, Leleux Olivier, van der Valk Marc, Boyd Anders, Monforte Antonella d'Arminio, Puoti Massimo, Zangerle Robert, Gisinger Martin, Logan Roger W, Rein Sophia, Hernán Miguel A, Lodi Sara
Аннотация
BACKGROUND: To inform hepatocellular carcinoma (HCC) surveillance after hepatitis C virus (HCV) cure with direct-acting antivirals (DAA), we estimated HCC risk post-DAA in people with human immunodeficiency virus (HIV) with advanced liver fibrosis or cirrhosis under universal DAA.
METHODS: We used data from HepCAUSAL, a collaboration of cohorts of HIV-HCV coinfection from Europe and North America. Eligibility criteria were HIV-HCV coinfection, advanced liver fibrosis or cirrhosis, DAA naïve, HIV-RNA < 50 copies/mL, on antiretroviral therapy, no HBV coinfection, and no prior HCC diagnosis or liver transplant. Follow-up started when eligibility was met and ended at HCC diagnosis, death, loss to follow-up, 6 years, or database closure, whichever came first. We estimated the 6-year risk and annual probability of HCC if all eligible individuals had initiated DAA at baseline using a weighted pooled logistic model for the monthly HCC risk among DAA initiators.
RESULTS: Of 3824 eligible individuals (92% males, median age 60 years [IQR: 54, 64]), 2373 (62%) who initiated DAA, 43 had an HCC diagnosis during follow-up. The estimated 6-year HCC risk (95% CI) under universal DAA was 2.5% (1.6, 3.9). Annual HCC probability was 0.81% (0.34, 1.54) between baseline and month 12 after DAA initiation, 0.64% (0.28, 1.19) between years 1 and 2, 0.50% (0.27, 0.84) between years 2 and 3, 0.34% (0.13, 0.63) between years 3 and 4, 0.19% (0.07, 0.33) between years 4 and 5, and 0.10% (0.01, 0.24) between years 5 and 6.
CONCLUSIONS: An estimated 2.5% of people with HIV and advanced liver fibrosis or cirrhosis are diagnosed with HCC by 6 years post-DAA. Annual probability of HCC declines over time and falls below 0.4% after 3 years.
METHODS: We used data from HepCAUSAL, a collaboration of cohorts of HIV-HCV coinfection from Europe and North America. Eligibility criteria were HIV-HCV coinfection, advanced liver fibrosis or cirrhosis, DAA naïve, HIV-RNA < 50 copies/mL, on antiretroviral therapy, no HBV coinfection, and no prior HCC diagnosis or liver transplant. Follow-up started when eligibility was met and ended at HCC diagnosis, death, loss to follow-up, 6 years, or database closure, whichever came first. We estimated the 6-year risk and annual probability of HCC if all eligible individuals had initiated DAA at baseline using a weighted pooled logistic model for the monthly HCC risk among DAA initiators.
RESULTS: Of 3824 eligible individuals (92% males, median age 60 years [IQR: 54, 64]), 2373 (62%) who initiated DAA, 43 had an HCC diagnosis during follow-up. The estimated 6-year HCC risk (95% CI) under universal DAA was 2.5% (1.6, 3.9). Annual HCC probability was 0.81% (0.34, 1.54) between baseline and month 12 after DAA initiation, 0.64% (0.28, 1.19) between years 1 and 2, 0.50% (0.27, 0.84) between years 2 and 3, 0.34% (0.13, 0.63) between years 3 and 4, 0.19% (0.07, 0.33) between years 4 and 5, and 0.10% (0.01, 0.24) between years 5 and 6.
CONCLUSIONS: An estimated 2.5% of people with HIV and advanced liver fibrosis or cirrhosis are diagnosed with HCC by 6 years post-DAA. Annual probability of HCC declines over time and falls below 0.4% after 3 years.