Módulo 2 – Curso pós-graduado – VIH e Envelhecimento

Non-AIDS Defining Cancers Among HIV Infected People

Clinical Management of non-AIDS defining cancers

Autor: Prof. Doutor Vicente Estrada, MD PhD (Hospital Clínico San Carlos, Madrid, Spain)

Hepatocellular carcinoma

Hepatocellular carcinoma (HCC) is a cancer related to hepatotropic virus, such as HBV or HCV, and develops faster in HIV patients. Most of them present cirrhosis before the develop ment of this carcinoma and many patients will present aggressive infiltrative tumors with extrahepatic metastases. Hence, it is recommended that patients with cirrhosis and HBV/HCV coinfection should be screened withhepatic ultrasound and alpha-fetoprotein(AFP)measurementat6to12monthlyintervals.

Treatment of HCC depends on the stage, the performance status of the liver disease and if surgery is possible. Hence, treatment includes resection, liver transplantation, radiofrequency, chemo embolization, sorafenib or, in the case of advanced cancers, supportive care11. The prognosis of an hepa- tocellular carcinoma is bad, with some studies showing a worst prognosis in HIV-infected patients12, 13.

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