Prevalence of HIV and HIV-Hepatitis B Co-Infection in Hepatocellular Carcinoma Patients in the Gambia, 2012-2019: A Prospective Cohort Study

2012-2019年冈比亚肝细胞癌患者中HIV和HIV-乙型肝炎合并感染的流行情况:一项前瞻性队列研究

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Abstract

BACKGROUND: HIV-hepatitis B co-infection rapidly progresses to fibrosis, cirrhosis, and HCC and has a poor prognosis. The study therefore assesses the prevalence of HIV and HIV-hepatitis B co-infection in the Gambia. METHODS: From June 2012 to September 2019, patients with confirmed diagnosis of HCC were enrolled. All patients medical history, ultrasound scan, fibroscan and laboratory details were collected. RESULTS: The study recruited 476 HCC patients. The prevalence of HIV amongst the HCC patient was 21 (4.4%), and this was higher in males, 19 (4.9%), than in females, 2 (2.2%). The HCC patients with Hepatitis B only were 319 (67.2%). Those HCC patients with HIV-hepatitis B co-infection were 17 (3.6%). HCC patients with HIV-hepatitis B co-infection were much younger and more likely to be male as compared to HCC patients with Hepatitis B only or HCC patients with negative HIV-hepatitis B. There was no difference between the median survivals of the three HCC patient groups. CONCLUSIONS: The prevalence of HIV in HCC patients is higher than in the general population. HIV-hepatitis B disproportionately affects young men, but there was no difference in survival. This study therefore confirms the need to have an integrated HIV-hepatitis B services in Hepatology clinics or screening programs in the Gambia to early detect co-infections, especially in young men and start them on treatment to prevent chronic liver disease complications and improve prognosis.

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