The albumin‐bilirubin grade uncovers the prognostic relationship between hepatic reserve and immune dysfunction in HIV‐associated hepatocellular carcinoma

• DOI: 10.1111/apt.14356
• Publication Date: 2017-10-16T09:19:08Z
• Authors: D. J. Pinato; R. Sharma; C. Citti; H. Platt; M. Ventura‐Cots; E. Allara; T.‐Y. Chen; A. Dalla Pria; M. Jain; B. Mínguez; L. Kikuchi; E. Kaufman West; M. Merli; D. E. Kaplan; H. Hasson; K. Marks; M. Nelson; M. Núñez; A. Aytaman; M. Bower; N. Bräu
• Keywords: Liver Cancer; Serum Albumin; Liver disease; Hepatitis C; Hepatitis B

Hepatocellular carcinoma (HCC) is a leading cause of liver-related mortality in people living with HIV, where co-infection hepatotropic viruses accelerates the course chronic liver disease.To evaluate whether albumin-bilirubin (ALBI) grade, more accurate marker dysfunction HCC, might identify patients progressive context HIV/hepatitis co-infection.Using uni- and multi-variable analyses, we studied grade as predictor overall survival (OS) large, multi-center cohort HIV-associated HCC recruited from 44 centres 9 countries within Liver Cancer HIV study group. Patients who underwent transplantation were excluded.A total 387 patients, predominantly HCV co-infected (78%) balanced representation all Barcelona Clinic (BCLC) stages (A = 33%, B 18%, C 37%, D 12%) recruited. At diagnosis, 84% had been on anti-retrovirals for median duration 8.8 years. The identified significant differences 97 months 1 (95% CI 13-180 months), 17 2 11-22 months) 6 3 4-9 months, P < .001). A advanced correlated lower CD4 counts (464/373/288 cells/mm3 grades 1/2/3) higher viraemia (3.337/8.701/61.845 copies/mL 1/2/3, .001).In this retrospective study, highlights interplay between reserve immune prognostic determinants HCC.