HIV associated hepatocellular cancer (HCC) in an inner-city minority population.

Abstract

e15680 Background: The Highly Active Anti-Retroviral Therapy (HAART) era has seen a rise in the incidence of non-AIDs defining cancers. This study was undertaken to study the characteristics associated with HIV+ HCC in an inner-city minority population. Methods: Patients with diagnosis of HCC since January 2011 until December 2018 were identified from our hospital’s electronic medical database using ICD-9/ICD-10 codes. Charts were retrospectively screened to confirm diagnosis of HCC and identify HIV+ patients. HIV+ HCC were compared to HIV- cohort from 2011 to 2016. Statistical analysis was done using the chi-square and t-test. Results: A total of 14 HIV+ HCCs were identified and compared to 239 HIV- HCC (Table 1). All HIV+ HCC were men (100%) with 86% African Americans (AA) (p < 0.05). HIV+ HCC were more likely to be HCV+, HBV+ and less likely to have history of alcoholism. Seventy-nine percent HIV+ HCC were Child-Pugh A at diagnosis compared to 35% in HIV- HCC. The median years between diagnosis of HIV and HCC was 18. All 14 HIV+ HCC (100%) were on HAART at the time of HCC diagnosis with viral load (available for 12) undetectable in 10 (83%) and < 100 copies/mL in 2 (17%). The average CD4 count at HCC diagnosis was 258 cells/µL with 10 (71%) having CD4 counts > 200 cells/µL. HCC was multifocal in 71% HIV+ compared to 49% of HIV- patients. AFP levels were < 20 ng/mL for 50% of the HIV+ HCC patients. There were 43% BCLC B and no BCLC D patients in HIV+ HCC compared to 17% and 24% in HIV- (p < 0.05 for both). 67% HIV+ BCLC Stage C patients died within 20 weeks of HCC diagnosis. Conclusions: HIV+ HCC is predominantly AA, exclusively male disease in our inner-city population. Compared to other studies showing HIV+ HCC to be younger than the HIV- patients, our HIV+ patients were similar in age to the HIV- cohort. HIV+ HCC is more multifocal with early mortality despite early BCLC stage.. Studies are needed to investigate if frequent HCC screening may be needed in HIV+ patients with HCV/HBV co-infection.[Table: see text]