ArticleJAMA network open2021
Trends in Hepatocellular Carcinoma Incidence and Risk Among Persons With HIV in the US and Canada, 1996-2015.
Article in JAMA network open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
30 citing papers in PubMed, 61 citations in OpenAlex.
- Liver disease in people living with HIV infection: a changing landscape.Nature reviews. Gastroenterology & hepatology · 2026Review
- Article
- Two-threshold defined immune non-responders are associated with long-term morbidity in people with HIV: a prospective cohort study.Emerging microbes & infections · 2025Article
- Concordance of cancer-associated cytokines and mitochondrial DNA deletions in individuals with hepatocellular carcinoma and people living with HIV in Ghana.BMC gastroenterology · 2025Article
- Current Tools to Diagnose and Predict Hepatocellular Carcinoma: Relevance to HIV and Hepatitis B Virus Coinfection.Current HIV/AIDS reports · 2025Review
- The role of liver macrophages in viral liver pathogenesis.Journal of leukocyte biology · 2025Review
- Differences in Trends in Cancer Incidence Rates Among People With HIV During 2001-2019 by Race and Ethnicity and by Risk Group in the United States.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Article
- Racial disparities in cancer risk among MSM with HIV in the United States.AIDS (London, England) · 2025Article
- Evaluating Challenges in Access To Transplantation for Persons with HIV.Current HIV/AIDS reports · 2025Review
- Tumor protein 53 gene polymorphism, demographic attributes and associated risk factors among liver cancer patients in Calabar, Nigeria.BMC cancer · 2025Article
- Plasma proteomic profiles of patients with HIV infection and coinfection with hepatitis B/C virus undergoing anti‑retroviral therapy.Biomedical reports · 2024Article
- Association of serum lipid profile with liver fibrosis in HCV‑coinfected HIV patients on suppressive 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
- Article
- Lower Incidence of HCC and Other Major Adverse Liver Outcomes in People Living With HIV and Chronic Liver Disease.Gastro hep advances · 2024Article
- Cancer screening in people living with HIV.Cancer medicine · 2023Review
- Review
- Hepatitis C Virus-HIV Coinfection in the United States Among People Who Inject Drugs: Data Needed for Ending Dual Epidemics.Public health reports (Washington, D.C. : 1974) · 2023Review
- HIV-HBV Coinfection-Current Challenges for Virologic Monitoring.Biomedicines · 2023Review
- The impact of HIV infection on clinical presentation and mortality among persons with hepatocellular carcinoma in Kampala, Uganda.BMC infectious diseases · 2023Article
Corrections and comments
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Authors and funding
27 authors at 17 institutions in 3 countries.
Funding
Abstract
Importance: People with HIV (PWH) are often coinfected with hepatitis B virus (HBV) and/or hepatitis C virus (HCV), leading to increased risk of developing hepatocellular carcinoma (HCC), but few cohort studies have had sufficient power to describe the trends of HCC incidence and risk among PWH in the combination antiretroviral therapy (cART) era. Objective: To determine the temporal trends of HCC incidence rates (IRs) and to compare rates by risk factors among PWH in the cART era. Design, Setting, and Participants: This cohort study used data from the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) study, which was conducted between 1996 and 2015. NA-ACCORD pooled individual-level data from 22 HIV clinical and interval cohorts of PWH in the US and Canada. PWH aged 18 years or older with available CD4 cell counts and HIV RNA data were enrolled. Data analyses were completed in March 2020. Exposures: HBV infection was defined as detection of either HBV surface antigen, HBV e antigen, or HBV DNA in serum or plasma any time during observation. HCV infection was defined by detection of anti-HCV seropositivity, HCV RNA, or detectable genotype in serum or plasma at any time under observation. Main Outcomes and Measures: HCC diagnoses were identified on the basis of review of medical records or cancer registry linkage. Results: Of 109 283 PWH with 723 441 person-years of follow-up, the median (interquartile range) age at baseline was 43 (36-51) years, 93 017 (85.1%) were male, 44 752 (40.9%) were White, 44 322 (40.6%) were Black, 21 343 (19.5%) had HCV coinfection, 6348 (5.8%) had HBV coinfection, and 2082 (1.9%) had triple infection; 451 individuals received a diagnosis of HCC by 2015. Between the early (1996-2000) and modern (2006-2015) cART eras, the crude HCC IR increased from 0.28 to 0.75 case per 1000 person-years. HCC IRs remained constant among HIV-monoinfected persons or those coinfected with HBV, but from 1996 to 2015, IRs increased among PWH coinfected with HCV (from 0.34 cases/1000 person-years in 1996 to 2.39 cases/1000 person-years in 2015) or those with triple infection (from 0.65 cases/1000 person-years in 1996 to 4.49 cases/1000 person-years in 2015). Recent HIV RNA levels greater than or equal to 500 copies/mL (IR ratio, 1.8; 95% CI, 1.4-2.4) and CD4 cell counts less than or equal to 500 cells/μL (IR ratio, 1.3; 95% CI, 1.0-1.6) were associated with higher HCC risk in the modern cART era. People who injected drugs had higher HCC risk compared with men who had sex with men (IR ratio, 2.0; 95% CI, 1.3-2.9), adjusted for HBV-HCV coinfection. Conclusions and Relevance: HCC rates among PWH increased significantly over time from 1996 to 2015. PWH coinfected with viral hepatitis, those with higher HIV RNA levels or lower CD4 cell counts, and those who inject drugs had higher HCC risk.
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