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Long-term suppression of HIV in AIDS patients with hepatitis B may reduce cancer risk
Long-term suppression of HIV with hepatitis B may reduce cancer risk. According to research by the Perelman School of Medicine at the University of Pennsylvania, although the risk of hepatocellular carcinoma (HCC, primary liver cancer) is higher in patients infected with HIV, it is higher in patients infected with HIV and detectable hepatitis B. Even higher among patients.
Among participants with HIV and hepatitis B, the use of antiretroviral therapy to suppress detectable hepatitis B infection can reduce the risk of developing HCC by 58%. These findings indicate that the best care for people with HIV and detectable hepatitis B includes continued suppression of hepatitis B with antiretroviral therapy to reduce the risk of HCC. The research was published in the journal Hepatology.
In the United States, HCC affects approximately 25,000 people each year and is considered a very aggressive cancer. Internationally and in the United States, chronic hepatitis B is a major cause of HCC through direct and indirect effects on the liver. In addition, chronic hepatitis B is common in patients infected with HIV.
To study the predictors of HCC among people with HIV and chronic hepatitis B co-infection, the researchers used data from the North American AIDS Cohort Research and Design Cooperation Organization, which contains health information spanning 20 years. The study population included data from more than 8,000 people who were co-infected with HIV and chronic hepatitis B.
Compared with those whose two viruses are suppressed, those who have detected HIV and hepatitis B are more likely to develop HCC. Antiretroviral therapy for chronic hepatitis B reduces the risk of HCC. When hepatitis B viremia is suppressed to an undetectable level and the virus suppression continues for at least one year, the risk is greatly reduced.
“Senior author Vincent Lo Re III, associate professor of medicine and epidemiology at the Pennsylvania Medical Association, said: “Most HIV providers do not regularly monitor hepatitis B viral load in practice, even when receiving antiretroviral therapy. “Our data emphasize the importance of regular evaluation of hepatitis B viral load during antiretroviral therapy and the realization of hepatitis B suppression for people with AIDS and chronic hepatitis B co-infection.”
In addition, maintaining compliance can be a challenge for some patients, depending on their overall health and other factors. “This study emphasizes the importance of testing and regular care for people with HIV and chronic hepatitis B co-infection, as well as the value of plans and strategies to help co-infected people adhere to antiretroviral therapy to the maximum extent to achieve hepatitis B virus suppression.”
According to Dr. Lo Re and his team, including lead author H. Nina Kim, associate professor of medicine at the University of Washington, heavy drinking and co-infection with hepatitis C are also associated with an increased risk of HCC in people who are co-infected with HIV and chronic hepatitis B.
The study authors suggest that reducing excessive alcohol consumption and the use of direct-acting antiviral therapies for chronic hepatitis C infection can also help reduce the risk of liver cancer in people with co-infection.
(source:internet, reference only)