• Annagiulia Gramenzi, Sara Tedeschi, Maria Chiara Cantarini, Virginia Erroi, Fabio Tumietto, Luciano Attard, Leonardo Calza, Francesco Giuseppe Foschi, Paolo Caraceni, Michele Pavoni, Alessandro Cucchetti, Mauro Bernardi, Pierluigi Viale, Gabriella Verucchi, and Franco Trevisani.
• Department of Medical and Surgical Sciences, Semeiotics Unit, Alma Mater Studiorum, University of Bologna, Bologna, Italy.
• Dig Liver Dis. 2013 Jun 1;45(6):516-22.

BackgroundAlthough the number of human immunodeficiency virus-infected patients with chronic liver disease is increasing, the impact of human immunodeficiency virus on hepatocellular carcinoma outcome remains unclear.AimsThis single centre study investigated whether human immunodeficiency virus infection per se affects the hepatocellular carcinoma prognosis.MethodsForty-eight human immunodeficiency virus-infected and 234 uninfected patients consecutively diagnosed with hepatitis virus-related hepatocellular carcinoma from January 2000 to December 2009 were retrospectively enrolled. Hepatocellular carcinoma was staged according to Cancer of the Liver Italian Program criteria. Survival and independent prognostic predictors were evaluated. Survivals were also compared after adjustment and matching by propensity score.ResultsCompared to human immunodeficiency virus-uninfected subjects, infected patients were more likely to be males, were younger, had fewer comorbidities and the tumour was more often detected during surveillance. Liver function, tumour characteristics and treatments did not significantly differ between the two groups. Nevertheless, median survival of human immunodeficiency virus-infected patients was approximately half that of their counterpart (16 months [95% confidence interval: 7-25] vs. 30 months [95% confidence interval: 25-35]; p=0.0354). Human immunodeficiency virus infection, Cancer of the Liver Italian Program score and hepatocellular carcinoma treatment were independently associated with mortality. Notably, human immunodeficiency virus infection doubled the risk of dying. These results were confirmed by propensity analysis.ConclusionHuman immunodeficiency virus infection per se worsens the prognosis of patients with virus-related hepatocellular carcinoma.Copyright © 2012 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

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