Maite Lewin MD, PhD, Presenter: Nothing to Disclose

Moana Gelu-Simeon, Abstract Co-Author: Nothing to Disclose

Marita Ostos, Abstract Co-Author: Nothing to Disclose

Faroudy Boufassa, Abstract Co-Author: Nothing to Disclose

Rodolphe Sobesky, Abstract Co-Author: Nothing to Disclose

Elina Teicher, Abstract Co-Author: Nothing to Disclose

Laurence Meyer, Abstract Co-Author: Nothing to Disclose

Helene Fontaine, Abstract Co-Author: Nothing to Disclose

Dominique Salmon, Abstract Co-Author: Nothing to Disclose

Didier Samuel, Abstract Co-Author: Nothing to Disclose

Olivier Seror, Abstract Co-Author: Nothing to Disclose

Jean-Claude Trinchet, Abstract Co-Author: Nothing to Disclose

Jean-Charles Duclos-Vallee, Abstract Co-Author: Nothing to Disclose

To characterize the diagnosis and prognosis imaging features of HCC using computed tomography (CT) or magnetic resonance imaging (MRI) in cirrhotic patients co-infected with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) compared to HCV mono-infected cirrhotic patients

Thirty-five HCC cases from two multicenter prospective cohorts of HIV-HCV cirrhotic patients (32 males; median age: 50 years [40-65]), and 35 mono-infected HCV cirrhotic patients from a control group (29 males; median age: 56 years [41-83]) were included. The CT or MRI analysis of HCCs focused on: (a) the detection of infiltrative or nodular types, (b) the evaluation of nodule size, and (c) evidence for portal obstructing tumors. Survival analysis used the Kaplan-Meier and Cox models. Our institutional review board approved the study and subjects provided written informed consent.

An infiltrative type was found in 8/35 HIV-HCV patients (23%) but was never found in HCV patients (p=0.002). Other HCCs were of a nodular type. The largest nodules had a median diameter that did not differ significantly between HIV-HCV and HCV patients (24 mm [12-70] and23 mm [13-90], respectively). A portal obstructing tumor was found in 10/35 HIV-HCV patients (28.5%) (including the 8 infiltrative types) but was never found in HCV patients (p=0.001). Survival was significantly shorter among HIV-HCV patients (p=0.004). The principal factors for a fatal outcome were an infiltrative type (adjusted HR:7.12 [2.59-19.60]) and portal obstructing tumor (aHR:4.82 [1.86-12.46]).

Compared to HCV mono-infected cirrhotic patients, HCCs in HIV-HCV co-infected cirrhotic patients were diagnosed at a more advanced stage, with a significantly higher rate of infiltrative types and of portal obstructing tumors, consistent with a shorter survival.

An earlier HCC detection using MR imaging rather than ultrasound is required in order to improve the access to curative treatment of HIV-HCV co-infected cirrhotic patients.

Lewin, M, Gelu-Simeon, M, Ostos, M, Boufassa, F, Sobesky, R, Teicher, E, Meyer, L, Fontaine, H, Salmon, D, Samuel, D, Seror, O, Trinchet, J, Duclos-Vallee, J, Imaging Diagnosis and Prognosis of Hepatocellular Carcinoma (HCC) in HIV-HCV Co-infected Cirrhotic Patients: Arguments for a New Screening Policy.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14007945.html