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Hepatitis C, Alcoholism Linked to Liver Cancer in HIV Patients

HIV status not a factor in hepatocellular carcinoma, large VA study finds

FRIDAY, Nov. 10 (HealthDay News) -- Although HIV-positive veterans have higher rates of hepatocellular carcinoma than HIV-negative veterans, alcoholism and hepatitis C virus appear to account for the increased risk, not HIV status, according to a paper in the Nov. 1 issue of the Journal of Clinical Oncology.

Kathleen A. McGinnis, M.S., of the Veterans Affairs Pittsburgh Healthcare System in Pennsylvania, and colleagues used the October 1997 to September 2004 Veteran Affairs Healthcare System database to identify 14,018 HIV-positive men and 28,036 HIV-negative controls to compare the incidence of hepatocellular carcinoma and non-Hodgkin lymphoma and the presence of hepatitis C virus and alcoholism between the two groups.

Although HIV-positive veterans had a higher independent relative risk (1.68) for liver cancer, HIV status was not independently associated after adjusting for hepatitis C virus and alcoholism. Similarly, after adjusting for hepatitis C virus and alcoholism, HIV status was not an independent risk factor for non-Hodgkin lymphoma, despite a 9.71-fold greater risk in HIV-positive men.

"HIV-positive veterans have a higher relative incidence of hepatocellular carcinoma and non-Hodgkin lymphoma than HIV-negative veterans. For hepatocellular carcinoma, this association appears to be largely explained by the higher prevalence of hepatitis C virus and alcohol abuse/dependence. Efforts to decrease hepatocellular carcinoma among persons with HIV should focus primarily on detecting and treating hepatitis C virus and reducing heavy alcohol use," the authors conclude.

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