Hepatocellular carcinoma presentation and prognosis among Nigerian adults with and without HIV.
<h4>Introduction</h4>Hepatocellular carcinoma (HCC) is an increasing cause of mortality in Nigeria among persons with HIV (PLH), as access to antiretroviral therapy (ART) improves. In this study we describe clinical, radiological, and laboratory characteristics in Nigerian adults with HC...
| Main Authors: | , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2023-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0282539 |
| _version_ | 1797842825709092864 |
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| author | Pantong M Davwar Edith Okeke Mary Duguru David Nyam Kristen Bell Emuobor A Odeghe Ganiat Oyeleke Olufunmilayo A Lesi Revika Singh Kwang-Youn Kim Godwin Imade Alani S Akanmu Atiene S Sagay Folasade T Ogunsola Marion G Peters Lewis R Roberts Lifang Hou Robert L Murphy Claudia A Hawkins |
| author_facet | Pantong M Davwar Edith Okeke Mary Duguru David Nyam Kristen Bell Emuobor A Odeghe Ganiat Oyeleke Olufunmilayo A Lesi Revika Singh Kwang-Youn Kim Godwin Imade Alani S Akanmu Atiene S Sagay Folasade T Ogunsola Marion G Peters Lewis R Roberts Lifang Hou Robert L Murphy Claudia A Hawkins |
| author_sort | Pantong M Davwar |
| collection | DOAJ |
| description | <h4>Introduction</h4>Hepatocellular carcinoma (HCC) is an increasing cause of mortality in Nigeria among persons with HIV (PLH), as access to antiretroviral therapy (ART) improves. In this study we describe clinical, radiological, and laboratory characteristics in Nigerian adults with HCC, with and without HIV, and examine how HIV impacts survival.<h4>Methods</h4>This prospective observational study was conducted between August 2018 and November 2021 at two Nigerian hospitals [Jos University Teaching Hospital (JUTH) and Lagos University Teaching Hospital (LUTH)]. Subjects ≥18 years with HCC diagnosed according to American Association for the Study of Liver Diseases (AASLD) criteria were included. Baseline characteristics were compared, and Kaplan-Meier curves were generated to estimate survival.<h4>Results</h4>213 subjects [177 (83%) without HIV and 36 (17%) with HIV (PLH)] were enrolled. Median age was 52 years (IQR 42,60) and most subjects were male (71%). 83% PLH were on antiretroviral therapy (ART). Hepatitis B surface antigen (HBsAg) positivity was similar between the two groups [91/177 (51%) without HIV vs. 18/36 (50%) with HIV; p = 0.86]. 46/213 (22%) subjects had active hepatitis C (anti-HCV+/HCV RNA>10 IU/mL). Cirrhosis was more common in PLH but there were no other significant differences in clinical and tumor characteristics between the groups. Overall, 99% subjects were symptomatic and 78% in late-stage HCC. Median overall survival was significantly shorter in PLH vs. without HIV (0.98 months vs 3.02 months, HR = 1.55, 95%CI 1.02, 2.37, p = 0.04). This association was not significant after adjusting for known risk factors including gender, current alcohol use, alpha-fetoprotein (AFP), albumin, and total bilirubin (HR = 1.38, 95%CI 0.84, 2.29, p = 0.21).<h4>Conclusion</h4>HCC presented late with an extremely poor overall prognosis, highlighting the urgent need for more intensive surveillance in Nigeria to diagnose HCC at earlier stages. Early diagnosis and management of viral hepatitis, and access to HCC therapies, could prevent early mortality among persons with HCC, especially among PLH. |
| first_indexed | 2024-04-09T16:55:40Z |
| format | Article |
| id | doaj.art-29cee3c26af6453cb88ee3e9a9bd3068 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-09T16:55:40Z |
| publishDate | 2023-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-29cee3c26af6453cb88ee3e9a9bd30682023-04-21T05:36:17ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-01183e028253910.1371/journal.pone.0282539Hepatocellular carcinoma presentation and prognosis among Nigerian adults with and without HIV.Pantong M DavwarEdith OkekeMary DuguruDavid NyamKristen BellEmuobor A OdegheGaniat OyelekeOlufunmilayo A LesiRevika SinghKwang-Youn KimGodwin ImadeAlani S AkanmuAtiene S SagayFolasade T OgunsolaMarion G PetersLewis R RobertsLifang HouRobert L MurphyClaudia A Hawkins<h4>Introduction</h4>Hepatocellular carcinoma (HCC) is an increasing cause of mortality in Nigeria among persons with HIV (PLH), as access to antiretroviral therapy (ART) improves. In this study we describe clinical, radiological, and laboratory characteristics in Nigerian adults with HCC, with and without HIV, and examine how HIV impacts survival.<h4>Methods</h4>This prospective observational study was conducted between August 2018 and November 2021 at two Nigerian hospitals [Jos University Teaching Hospital (JUTH) and Lagos University Teaching Hospital (LUTH)]. Subjects ≥18 years with HCC diagnosed according to American Association for the Study of Liver Diseases (AASLD) criteria were included. Baseline characteristics were compared, and Kaplan-Meier curves were generated to estimate survival.<h4>Results</h4>213 subjects [177 (83%) without HIV and 36 (17%) with HIV (PLH)] were enrolled. Median age was 52 years (IQR 42,60) and most subjects were male (71%). 83% PLH were on antiretroviral therapy (ART). Hepatitis B surface antigen (HBsAg) positivity was similar between the two groups [91/177 (51%) without HIV vs. 18/36 (50%) with HIV; p = 0.86]. 46/213 (22%) subjects had active hepatitis C (anti-HCV+/HCV RNA>10 IU/mL). Cirrhosis was more common in PLH but there were no other significant differences in clinical and tumor characteristics between the groups. Overall, 99% subjects were symptomatic and 78% in late-stage HCC. Median overall survival was significantly shorter in PLH vs. without HIV (0.98 months vs 3.02 months, HR = 1.55, 95%CI 1.02, 2.37, p = 0.04). This association was not significant after adjusting for known risk factors including gender, current alcohol use, alpha-fetoprotein (AFP), albumin, and total bilirubin (HR = 1.38, 95%CI 0.84, 2.29, p = 0.21).<h4>Conclusion</h4>HCC presented late with an extremely poor overall prognosis, highlighting the urgent need for more intensive surveillance in Nigeria to diagnose HCC at earlier stages. Early diagnosis and management of viral hepatitis, and access to HCC therapies, could prevent early mortality among persons with HCC, especially among PLH.https://doi.org/10.1371/journal.pone.0282539 |
| spellingShingle | Pantong M Davwar Edith Okeke Mary Duguru David Nyam Kristen Bell Emuobor A Odeghe Ganiat Oyeleke Olufunmilayo A Lesi Revika Singh Kwang-Youn Kim Godwin Imade Alani S Akanmu Atiene S Sagay Folasade T Ogunsola Marion G Peters Lewis R Roberts Lifang Hou Robert L Murphy Claudia A Hawkins Hepatocellular carcinoma presentation and prognosis among Nigerian adults with and without HIV. PLoS ONE |
| title | Hepatocellular carcinoma presentation and prognosis among Nigerian adults with and without HIV. |
| title_full | Hepatocellular carcinoma presentation and prognosis among Nigerian adults with and without HIV. |
| title_fullStr | Hepatocellular carcinoma presentation and prognosis among Nigerian adults with and without HIV. |
| title_full_unstemmed | Hepatocellular carcinoma presentation and prognosis among Nigerian adults with and without HIV. |
| title_short | Hepatocellular carcinoma presentation and prognosis among Nigerian adults with and without HIV. |
| title_sort | hepatocellular carcinoma presentation and prognosis among nigerian adults with and without hiv |
| url | https://doi.org/10.1371/journal.pone.0282539 |
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