Hepatocellular carcinoma in HIV positive patients

G. Nunnari 1,2, M. Berretta 3, M.R. Pinzone 1, M. Di Rosa 1, S. Berretta 4, G. Cunsolo 4, M. Malaguarnera 5, S. Cosentino 1, P. De Paoli 6, J.M. Schnell 2, B. Cacopardo 1

1 Department of Clinical and Molecular Biomedicine, Division of Infectious Diseases, University of Catania, Catania, Italy. gnunnari@hotmail.com
2 Department of Microbiology and Immunology, Jefferson Medical College, Thomas Jefferson
University, Philadelphia, PA, USA
3 Department of Medical Oncology, National Cancer Institute, Aviano, PN, Italy
4 Department of Surgery, General Surgery and Senology Unit, University of Catania, Catania, Italy
5 Department of Biological Chemistry, Medical Chemistry, and Molecular Biology, University of
Catania, Italy
6 Scientific Direction, National Center Institute, Aviano, Pordenone, Italy

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• Oncology

Highly active antiretroviral therapy (HAART) has dramatically changed the natural history of HIV-1-infected patients leading to increased survival and a better quality of life. Hepatitis C virus (HCV) and hepatitis B virus (HBV) infections are common among HIV-1-infected subjects and represent the most important risk factors for hepatocellular carcinoma (HCC). Whether HIV plays a direct role in hepatocellular carcinoma (HCC) pathogenesis remains to be established.

HCC clinical course depends on stage of cancer disease, performance status and comorbidities. Therapeutic options include liver transplantation, local antiblastic chemotherapy and biological drugs. In the HIV setting few data are available about treatment options. The increased longevity of patients with HIV imposes new strategies for prevention and therapeutic management of patients. The aim of this article is to provide an up-to-date review of HIV-related HCC in the HAART era.