ArticleJournal of the National Cancer Institute2020
HIV RNA, CD4+ Percentage, and Risk of Hepatocellular Carcinoma by Cirrhosis Status.
Article in Journal of the National Cancer Institute, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 29 citations in OpenAlex.
- HIV, Viral Hepatitis, and Schistosomiasis Association with Liver Cancer: A Systematic Review.Microorganisms · 2025Review
- Current Tools to Diagnose and Predict Hepatocellular Carcinoma: Relevance to HIV and Hepatitis B Virus Coinfection.Current HIV/AIDS reports · 2025Review
- Risk Score for Hepatocellular Cancer in Adults Without Viral Hepatitis or Cirrhosis.JAMA network open · 2024Article
- Plasma proteomic profiles of patients with HIV infection and coinfection with hepatitis B/C virus undergoing anti‑retroviral therapy.Biomedical reports · 2024Article
- Risk of hepatocellular carcinoma in people with HIV in the United States, 2001-2019.Journal of the National Cancer Institute · 2024Article
- Lower Incidence of HCC and Other Major Adverse Liver Outcomes in People Living With HIV and Chronic Liver Disease.Gastro hep advances · 2024Article
- Incomplete immune reconstitution and its predictors in people living with HIV in Wuhan, China.BMC public health · 2023Article
- HIV and liver disease: a comprehensive update.Topics in antiviral medicine · 2022Article
- A simple CD4+ T cells to FIB-4 ratio for evaluating prognosis of BCLC-B hepatocellular carcinoma: a retrospective cohort study.BMC cancer · 2022Article
- Loco-Regional Treatments for Hepatocellular Carcinoma in People Living with HIV.Infectious disease reports · 2022Review
- Liver Transplantation for HCC in HIV-Infected Patients: Long-Term Single-Center Experience.Cancers · 2021Article
- Risk of HCC With Hepatitis B Viremia Among HIV/HBV-Coinfected Persons in North America.Hepatology (Baltimore, Md.) · 2021Article
- Associations Between Plasma Human Immunodeficiency Virus (HIV) Ribonucleic Acid Levels and Incidence of Invasive Cancer in People With HIV After Initiation of Combination Antiretroviral Therapy.Open forum infectious diseases · 2021Article
- Chronic Hepatitis B and HIV Coinfection: A Continuing Challenge in the Era of Antiretroviral Therapy.Current hepatology reports · 2020Article
- The role of MDM2-p53 axis dysfunction in the hepatocellular carcinoma transformation.Cell death discovery · 2020Review
- A Review of Chronic Comorbidities in Adults Living With HIV: State of the Science.The Journal of the Association of Nurses in AIDS Care : JANACReview
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Authors and funding
17 authors at 9 institutions in 2 countries.
Funding
Abstract
backgroundDespite increasing incidence of hepatocellular carcinoma (HCC) among HIV-infected patients, it remains unclear if HIV-related factors contribute to development of HCC. We examined if higher or prolonged HIV viremia and lower CD4+ cell percentage were associated with HCC.
methodsWe conducted a cohort study of HIV-infected individuals who had HIV RNA, CD4+, and CD8+ cell counts and percentages assessed in the Veterans Aging Cohort Study (1999-2015). HCC was ascertained using Veterans Health Administration cancer registries and electronic records. Cox regression was used to determine hazard ratios (HR, 95% confidence interval [CI]) of HCC associated with higher current HIV RNA, longer duration of detectable HIV viremia (≥500 copies/mL), and current CD4+ cell percentage less than 14%, adjusting for traditional HCC risk factors. Analyses were stratified by previously validated diagnoses of cirrhosis prior to start of follow-up.
resultsAmong 35 659 HIV-infected patients, 302 (0.8%) developed HCC over 281 441 person-years (incidence rate = 107.3 per 100 000 person-years). Among patients without baseline cirrhosis, higher HIV RNA (HR = 1.25, 95% CI = 1.12 to 1.40, per 1.0 log10 copies/mL) and 12 or more months of detectable HIV (HR = 1.47, 95% CI = 1.02 to 2.11) were independently associated with higher risk of HCC. CD4+ percentage less than 14% was not associated with HCC in any model. Hepatitis C coinfection was a statistically significant predictor of HCC regardless of baseline cirrhosis status.
conclusionAmong HIV-infected patients without baseline cirrhosis, higher HIV RNA and longer duration of HIV viremia increased risk of HCC, independent of traditional HCC risk factors. This is the strongest evidence to date that HIV viremia contributes to risk of HCC in this group.
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