ArticleBMC infectious diseases2023
The impact of HIV infection on clinical presentation and mortality among persons with hepatocellular carcinoma in Kampala, Uganda.
Article in BMC infectious diseases, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 7 citations in OpenAlex.
- HIV, Viral Hepatitis, and Schistosomiasis Association with Liver Cancer: A Systematic Review.Microorganisms · 2025Review
- Prevalence of HIV and HIV-Hepatitis B Co-Infection in Hepatocellular Carcinoma Patients in the Gambia, 2012-2019: A Prospective Cohort Study.Health science reports · 2025Article
- Pragmatic Approach to Hepatocellular Carcinoma Diagnosis in High-Incidence, Resource-Limited Settings in Africa.JCO global oncology · 2025Article
- Case Report: Extensive colonic necrosis and perforation in an HIV patient with syphilis complicated by sepsis.Frontiers in medicine · 2025Article
- Cancer patterns in Arua district, Uganda: a hospital-based retrospective study.Ecancermedicalscience · 2024Article
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Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundHIV infection is associated with more rapid progression of some comorbidities. This study assessed the impact of HIV-infection on the presentation and outcome of HCC.
methodsHCC patients attending the Mulago National Referral Hospital in Uganda were enrolled into a natural history study of HCC between March 2015 and February 2019. Standardized methods were used to collect clinical, ultrasound and laboratory data at enrolment. HCC cases were confirmed and enrolled based on a combination of clinical, ultrasound, tumor marker and pathology data. Follow-up contact was made at one, three, six, and twelve months post-enrolment to determine vital status. Symptoms and signs at diagnosis and subsequent survival were compared by HIV status. Kaplan Meier curves were used to assess HCC survival.
resultsOf 441 persons with HCC, 383 (87.0%) died within 12 months following HCC diagnosis. The median (IQR) survival was 42 (20, 106) days. HIV infection was present in 79 (18%) cases. After adjusting for baseline demographic and clinical characteristics, HIV infection was associated with increased mortality but only among those with severe HIV-associated immunosuppression (CD4 count < 200 cells per cubic milliliter), aHR (95% C) = 2.12 (1.23-3.53), p = 0.004, and not among PLWH with ≥ 200 CD4 cells per cubic milliliter, aHR (95% C) = 1.15 (0.82-1.60), p = 0.417.
conclusionAmong relatively young Ugandans, HCC is a devastating disease with rapid mortality that is especially rapid among people living with HIV(PLWH). HIV was associated with slightly higher mortality, notably among PLWH with lower CD4 cell counts. As a substantial majority of PLWH diagnosed with HCC were engaged in HIV care, further investigation should determine the effectiveness of incorporating screening and early identification of HCC among high-risk individuals into existing HIV care programs. Concurrent with growing access to curative localized treatment for HCC in sub-Saharan Africa, leveraging HIV care infrastructure affords opportunities for earlier HCC intervention.
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