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

التفاصيل البيبلوغرافية
العنوان: The albumin-bilirubin grade uncovers the prognostic relationship between hepatic reserve and immune dysfunction in HIV-associated hepatocellular carcinoma.
المؤلفون: Pinato, DJ, Sharma, R, Citti, C, Platt, H, Ventura-Cots, M, Allara, E, Chen, T-Y, Dalla Pria, A, Jain, M, Mínguez, B, Kikuchi, L, Kaufman West, E, Merli, M, Kaplan, DE, Hasson, H, Marks, K, Nelson, M, Núñez, M, Aytaman, A, Bower, M, Bräu, N, Liver Cancer in HIV Study Group
بيانات النشر: Wiley
//dx.doi.org/10.1111/apt.14356
Aliment Pharmacol Ther
سنة النشر: 2018
المجموعة: Apollo - University of Cambridge Repository
مصطلحات موضوعية: Adult, Aged, Bilirubin, Biomarkers, Carcinoma, Hepatocellular, Coinfection, Female, HIV Infections, Humans, Liver Function Tests, Liver Neoplasms, Male, Middle Aged, Neoplasm Staging, Prognosis, Retrospective Studies, Serum Albumin
الوصف: BACKGROUND: Hepatocellular carcinoma (HCC) is a leading cause of liver-related mortality in people living with HIV, where co-infection with hepatotropic viruses accelerates the course of chronic liver disease. AIM: To evaluate whether the albumin-bilirubin (ALBI) grade, a more accurate marker of liver dysfunction in HCC, might identify patients with progressive liver dysfunction in the context of HIV/hepatitis co-infection. METHODS: Using uni- and multi-variable analyses, we studied the albumin-bilirubin grade as a predictor of overall survival (OS) in a large, multi-center cohort of patients with HIV-associated HCC recruited from 44 centres in 9 countries within the Liver Cancer in HIV study group. Patients who underwent liver transplantation were excluded. RESULTS: A total of 387 patients, predominantly HCV co-infected (78%) with balanced representation of all Barcelona Clinic Liver Cancer (BCLC) stages (A = 33%, B = 18%, C = 37%, D = 12%) were recruited. At HCC diagnosis, 84% had been on anti-retrovirals for a median duration of 8.8 years. The albumin-bilirubin grade identified significant differences in median survival of 97 months for grade 1 (95% CI 13-180 months), 17 months for grade 2 (95% CI 11-22 months) and 6 months for grade 3 (95% CI 4-9 months, P < .001). A more advanced albumin-bilirubin grade correlated with lower CD4 counts (464/373/288 cells/mm3 for grades 1/2/3) and higher HIV viraemia (3.337/8.701/61.845 copies/mL for grades 1/2/3, P < .001). CONCLUSIONS: In this large, multi-center retrospective study, the albumin-bilirubin grade highlights the interplay between liver reserve and immune dysfunction as prognostic determinants in HIV-associated HCC.
نوع الوثيقة: article in journal/newspaper
وصف الملف: Print-Electronic; application/pdf
اللغة: English
العلاقة: https://www.repository.cam.ac.uk/handle/1810/275850Test
DOI: 10.17863/CAM.23118
الإتاحة: https://doi.org/10.17863/CAM.23118Test
https://www.repository.cam.ac.uk/handle/1810/275850Test
رقم الانضمام: edsbas.E6FFE313
قاعدة البيانات: BASE
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