Retrospective analysis of patients with hepatocellular carcinoma complicated with human immunodeficiency virus infection after hepatectomy

doi:10.4251/wjgo.v16.i9.3851

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World Journal of Gastrointestinal Oncology

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Retrospective Cohort Study

World J Gastrointest Oncol. Sep 15, 2024; 16(9): 3851-3864
Published online Sep 15, 2024. doi: 10.4251/wjgo.v16.i9.3851

Table 1 Clinical data for patients in the surgery group

Indicator	n = 27
Age (years)	60.15 ± 5.90
Gender (Male:female)	24:3
HIV initial diagnosis, n (%)	20 (74.1)
HIV-RNA positive, n (%)	13 (48.1)
MSM, n (%)	18 (66.7)
Received HART after HIV diagnosis	21 (77.8)
HBV, n (%)	21 (77.8)
HCV, n (%)	2 (7.4)
Chronic alcohol consumption, n (%)	11 (40.7)
PS score (0-1:2-3)	16:11
CD4+ cell count < 200 (cell/μL)	15 (55.6)
Child-Pugh score (A:B)	21:6
BCLC staging (0-B:C-D)	10:17
CNLC Staging (Ia-IIa:IIb-IIIa)	18:9
AFP (ng/mL)	249.00 (3.56-2287.42)
ALT (U/L)	31.48 ± 22.39
AST (U/L)	37.44 ± 26.24
TBIL	16.31 ± 9.37
DBIL	5.62 ± 4.15
IBIL	10.68 ± 6.53
Prothrombin time (second)	13.55 ± 2.35
Albumin	36.88 ± 5.36
Hemoglobin	135.11 ± 13.37
White blood cell count (/L)	4.84 ± 1.66
Platelet count (/L)	127.11 ± 91.61
Tumor maximum diameter (mm)	46 (15-130)
Tumor solitary:multiple	10:17
Hepatic encephalopathy (n)	0
Ascites, n (%)	11 (40.7)
Intraoperative blood loss (50-200:300-500)	19: 8
Hepatic artery embolization, n (%)	12 (44.4)
Postoperative recurrence and retreatment, n (%)	12 (44.4)
Postoperative MVI	8 (29.6)
Tumor capsule, n (%)	12 (44.4)
PDL1 positive, n (%)	17 (63.0)

HART: Highly active antiretroviral therapy; HIV: Human immunodeficiency virus; MSM: Men who have sex with men; HBV: Hepatitis B Virus; HCV: Hepatitis C Virus; AFP: Alpha-fetoprotein; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; TBIL: Total bilirubin; DBIL: Direct bilirubin; IBIL: Indirect bilirubin; MVI: Microvascular invasion.

Table 2 Clinical data for patients in the nonsurgical group

Indicator	n = 29
Age (years)	60.38 ± 7.49
Gender (Male:female)	23:6
HIV initial diagnosis, n (%)	17 (58.6)
HIV-RNA positive, n (%)	20 (69.0)
MSM, n (%)	14 (48.3)
Received HART after HIV diagnosis	12 (41.4)
HBV, n (%)	21 (72.4)
HCV, n (%)	4 (13.8)
Chronic alcohol consumption, n (%)	11 (37.9)
CD4+ cell count < 200 (cell/μL)	18 (62.1)
Child-Pugh score (A:B)	14:15
BCLC staging (0-B:C-D)	12:17
CNLC Staging (Ia-IIa:IIb-IIIa)	14:15
AFP (ng/mL)	179.01 (1.64-848.74)
ALT (U/L)	23.66 ± 17.51
AST (U/L)	29.00 ± 20.56
TBIL	14.98 ± 6.82
DBIL	4.29 ± 2.49
IBIL	10.96 ± 4.86
Prothrombin time (second)	13.82 ± 2.11
Albumin	34.37 ± 5.43
Hemoglobin	129.55 ± 14.46
White blood cell count (/L)	5.41 ± 3.95
Platelet count (/L)	168.14 ± 73.22
Tumor maximum diameter (mm)	37 (9-115)
Tumor solitary:multiple	13:16
Hepatic encephalopathy (n)	0
Ascites, n (%)	7 (24.1)
PS score (0-1:2-3, cases)	19:10

Table 3 Comparison of clinical parameters between the surgery and non-surgery groups

Clinical parameters	Surgery group	Non-surgery group	P value
Age (years)	60.15 ± 5.90	60.38 ± 7.49	0.223
Gender (male:female)	24:3	23:6	0.472
HBV (positive:negative)	6:21	8:21	0.643
HCV (positive:negative)	2:25	4:25	0.440
CD4+ cell count < 200 (cell/μL)	15 (55.6)	18 (62.1)	0.621
HIV initial diagnosis, n (%)	20 (69.0)	17 (58.6)	0.222
HIV-RNA positive, n (%)	13 (48.1)	20 (69.0)	0.114
Initiation of HART therapy after HIV diagnosis, n (%)	21 (77.8)	12 (41.1)	0.006^a
MSM, n (%)	18 (66.7)	14 (48.3)	0.269
Child-Pugh score (A:B)	21:6	14:15	0.023^a
BCLC stage (0-B:C-D)	10:17	12:17	0.740
CNLC stage (Ia-IIa:IIb-IIIa)	18:9	14:15	0.165
AFP (ng/mL)	249.00 (3.56-2287.42)	179.01 (1.64-848.74)	0.010^a
ALT (U/L)	31.48 ± 22.39	23.66 ± 17.51	0.149
AST (U/L)	37.44 ± 26.24	29.00 ± 20.56	0.184
TBIL	16.31 ± 9.37	14.98 ± 6.82	0.535
DBIL	5.62 ± 4.15	4.29 ± 2.49	0.148
IBIL	10.68 ± 6.53	10.96 ± 4.86	0.859
Prothrombin time (S)	13.55 ± 2.35	13.82 ± 2.11	0.654
Albumin	36.88 ± 5.36	34.37 ± 5.43	0.088
Hemoglobin	135.11 ± 13.37	129.55 ± 14.46	0.142
White blood cell count (/L)	4.84 ± 1.66	5.41 ± 3.95	0.480
Platelet count (/L)	127.11 ± 91.61	168.14 ± 73.22	0.069
Tumor maximum diameter (mm)	46 mm (15-130 mm)	37 mm (9-115 mm)	0.113
Tumor single:multiple	10:17	13:16	0.554
Ascites, n (%)	11 (40.7)	7 (24.1)	0.184
PS score (0-1:2-3)	16:11	19:10	0.629

^aP < 0.05.

Table 4 Single-factor Cox regression analysis of factors influencing overall survival in the surgical group

Indicator	Cases	95%CI	P value
MSM		1.216-9.629	0.020^a
Y	18
N	9
HIV initial diagnosis		1.023-9.643	0.046^a
Y	20
N	7
BCLC staging		3.241-232.007	0.002^a
0-B	10
C-D	17
MVI		1.655-16.822	0.005^a
Y	8
N	19
CD4 cell count < 200 (cell/μL)		1.264-9.031	0.015^a
Y	8
N	19

^aP < 0.05.

Y: Yes; N: No; MSM: Men who have sex with men; HIV: Human immunodeficiency virus; MVI: Microvascular -nvasion.

Table 5 Single-factor Cox regression analysis of factors influencing disease-free survival in the surgical group

Indicator	Cases	95%CI	P value
MSM		1.041-8.787	0.042^a
Y	18
N	9
HIV initial diagnosis		1.024-10.275	0.046^a
Y	20
N	7
BCLC staging		2.671-190.106	0.004^a
0-B	10
C-D	17
MVI		1.616-21.383	0.007^a
Y	8
N	19
CD4 cell count <200 (cell/μL)		1.052-8.614	0.040^a
Y	8
N	19

^aP < 0.05.

Y: Yes; N: No; MSM: Men who have sex with men; HIV: Human immunodeficiency virus; MVI: Microvascular invasion.

Table 6 Multifactor Cox regression analysis of factors influencing overall survival in the surgical group

Factor	B	SE	Wald	P value	Exp(B)	95%CI
HIV initial diagnosis	-2.402	1.606	2.238	0.135	0.091	0.004, 2.106
CD4 cell count < 200 (cell/μL)	-1.116	0.836	1.783	0.182	0.327	0.064, 1.686
BCLC staging	6.482	2.479	6.839	0.009^a	653.193	5.072, 84118.343
MSM	3.534	1.682	4.415	0.036^a	34.252	1.268, 925.153
MVI	0.022	0.606	0.001	0.972	1.022	0.311, 3.352

^aP < 0.05.

HIV: Human immunodeficiency virus; MSM: Men who have sex with men; MVI: Microvascular invasion.

Table 7 Multifactorial Cox regression analysis of factors influencing disease-free survival in the surgical group

Factor	B	SE	Wald	P value	Exp(B)	95%CI
HIV initial diagnosis	-3.770	1.728	4.762	0.029^a	0.023	0.001, 0.681
CD4 cell count < 200 (cell/μL)	-1.699	1.093	2.415	0.120^a	0.183	0.021, 1.558
BCLC staging	8.138	2.841	8.207	0.004^a	3421.835	13.072, 895725.580
MSM	4.366	1.692	6.661	0.010^a	78.746	2.859, 2169.024
MVI	-0.479	0.702	0.464	0.496	0.620	0.156, 2.455

^aP < 0.05.

HIV: Human immunodeficiency virus; MSM: Men who have sex with men; MVI: Microvascular invasion.

Citation: Lu JJ, Yan S, Chen L, Ju LL, Cai WH, Wu JZ. Retrospective analysis of patients with hepatocellular carcinoma complicated with human immunodeficiency virus infection after hepatectomy. World J Gastrointest Oncol 2024; 16(9): 3851-3864
URL: https://www.wjgnet.com/1948-5204/full/v16/i9/3851.htm
DOI: https://dx.doi.org/10.4251/wjgo.v16.i9.3851