Abstract
Purpose: Hepatocellular carcinoma (HCC) is a major public health problem in West African countries. HCC still has a strikingly high mortality in this region. Whether HIV also contributes to an increased risk of HCC is in this region is unclear. In this study we describe clinical, radiological and laboratory features as well as survival in Nigerians with HCC, with and without HIV infection, enrolled in an NCI-funded study.
Methods: This was a prospective, non-interventional study conducted at two Nigerian tertiary hospitals [Jos University Teaching Hospital and Lagos University Teaching Hospital. Subjects>18 years with HCC diagnosed according to AASLD criteria were included.
Results: 204 participants were included in this study [males 144 (71%), median age 50 yrs (IQR 19, 86); HIV-infected (25 (12%)]. 51(27.6%) of all subjects were anti-HCV positive [HIV-uninfected 46 (28.4%) vs. HIV-infected 5(21.7%); p=0.62]. 62% of anti-HCV positive patients at JUTH were confirmed to have active infection (HCV RNA>10IU/mL). Median CD4 T cell count among HIV-infected was 236.50 [61.00-479.00] cells/mm3. 72% of the HIV patients were on ART. Tumor mass diameter on computed tomography did not differ between subject groups [HIV-infected 6.5cm (1.80-80.00) vs. HIV-uninfected 8.9 cm (1-93.0); p=0.23). Overall median survival for both groups was 2.04 months CI (1.58, 4.47). The mean probability of survival at month 1 was 0.7 (95% CI, 0.6, 0.8).
Conclusion: A very short median survival was observed in this cohort of HIV-infected and uninfected Nigerian adults with HCC. Almost a third of all subjects were anti-HCV positive and two thirds of these subjects had active infection suggesting HCV infection is an important, risk factor for HCC in this setting.
Citation Format: Pantong Davwar, Emoubor Odeghe, Mary Duguru, Ganiat Oyeleke, David Nyam, Edith Okeke, Olufunmi Lesi, Kwang-youn Kim, Godwin Imade, Alani Akanmu, Atiene Sagay, Lewis Robert, Lifang Hou, Rob Murphy, Claudia Hawkins. Characteristics of Hepatocellular Carcinoma in Nigerians with and without HIV [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 32.