Risk of Hepatocellular Carcinoma or Hepatic Decompensation Associated With Steatotic Liver Disease in People With and Without HIV.
10 affiliations
- 1Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
- 2Department of Biostatistics, Epidemiology, and Informatics, Center for Clinical Epidemiology and Biostatistics, Center for Real-World Effectiveness and Safety of Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
- 3VA Connecticut Healthcare System, West Haven, Connecticut, USA.
- 4Department of Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
- 5Center for Pharmacoepidemiology and Treatment Science, Institute for Health, Health Care Policy, and Aging Research, Rutgers University, New Brunswick, New Jersey, USA.
- 6Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
- 7VA Greater Los Angeles Healthcare System and Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
- 8Department of Medicine, University of California, San Francisco School of Medicine, San Francisco, California, USA.
- 9Division of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut, USA.
- 10Division of Infectious Diseases, Department of Medicine, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey, USA.
Abstract
Background
Steatotic liver disease (SLD) is highly prevalent in people with HIV (PWH), but factors influencing progression to hepatocellular carcinoma (HCC) and hepatic decompensation (HD) remain unclear. It is unknown if the risk of these outcomes associated with SLD differs by HIV status.Methods
Patients from the Veterans Aging Cohort Study-HIV (includes matched people without HIV [PWoH]) who underwent an ultrasound, computed tomography, or magnetic resonance imaging between 2001-2017 were included. Patients with diagnosed cirrhosis or chronic viral hepatitis were excluded. SLD was defined by a natural language processing algorithm; primary outcome of composite of HCC or HD was defined using International Classification of Diseases 9/10 codes and national cancer registry. Follow-up began on imaging study date and continued until incident HCC/HD, death, or 31 December 2024. Adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs) of HCC/HD associated with SLD and HIV status were calculated.Results
Among 19 546 patients (mean age: 54 years; 96.6% male; 28.6% PWH), 13 617 (69.7%) had SLD identified by natural language processing. Rates of HCC/HD were lowest in PWoH and no SLD (18.0/10 000 person-years) and highest among PWH and SLD (46.8/10 000 person-years). When compared to PWoH without SLD, risk of HCC/HD was increased among PWH with SLD (aHR: 2.71; 95% CI: 2.10-3.49) and PWH without SLD (aHR: 1.62; 95% CI: 1.14-2.29), although no interaction between HIV and SLD was observed (P = .25).Conclusions
Among people without cirrhosis or chronic viral hepatitis, radiographic findings of SLD were associated with increased rates of HCC/HD, with the highest rate among PWH and SLD, independent of cardiometabolic factors, alcohol, and tobacco.
Related
- Association of steatotic liver disease with long-term oncological outcomes after hepatic resection for hepatocellular carcinoma
- The CYB5R3–mARC1 Redox Axis in Metabolic Dysfunction-associated Steatotic Liver Disease: Mechanistic Basis and Therapeutic Prospects across the Steatosis–Cirrhosis–Hepatocellular Carcinoma Spectrum
- Hepatocellular Carcinoma Associated with Hepatic Sarcoidosis and Budd-Chiari Syndrome: A Case Report and Review of the Literature
- Hepatic stellate cells drive hypoxia-inducible factor (HIF)-dependent metabolic rewiring and proliferation in hepatocellular carcinoma cells
- Hepatic arterial infusion chemotherapy plus lenvatinib and programmed death receptor 1 inhibitor for hepatocellular carcinoma with portal vein tumor thrombosis: a prospective controlled study
BibTeX
@article{torgersen2026risk,
title = {{Risk of Hepatocellular Carcinoma or Hepatic Decompensation Associated With Steatotic Liver Disease in People With and Without HIV.}},
author = {Jessie Torgersen and Craig W Newcomb and Melissa Skanderson and Farah Kidwai-Khan and Dean M Carbonari and Janet P Tate and Catherine Mezzacappa and Emily J Cartwright and Debika Bhattacharya and Joseph K Lim and Jennifer C Price and Tamar H Taddei and Amy C Justice and Vincent Lo Re},
journal = {Open forum infectious diseases},
year = {2026},
month = oct,
doi = {10.1093/ofid/ofag617},
url = {https://europepmc.org/article/MED/42898815},
note = {CC BY},
}
RIS
TY - JOUR
TI - Risk of Hepatocellular Carcinoma or Hepatic Decompensation Associated With Steatotic Liver Disease in People With and Without HIV.
AU - Jessie Torgersen
AU - Craig W Newcomb
AU - Melissa Skanderson
AU - Farah Kidwai-Khan
AU - Dean M Carbonari
AU - Janet P Tate
AU - Catherine Mezzacappa
AU - Emily J Cartwright
AU - Debika Bhattacharya
AU - Joseph K Lim
AU - Jennifer C Price
AU - Tamar H Taddei
AU - Amy C Justice
AU - Vincent Lo Re
PY - 2026
DA - 2026/10/07
JO - Open forum infectious diseases
DO - 10.1093/ofid/ofag617
UR - https://europepmc.org/article/MED/42898815
AB - Background Steatotic liver disease (SLD) is highly prevalent in people with HIV (PWH), but factors influencing progression to hepatocellular carcinoma (HCC) and hepatic decompensation (HD) remain unclear. It is unknown if the risk of these outcomes associated with SLD differs by HIV status.Methods Patients from the Veterans Aging Cohort Study-HIV (includes matched people without HIV [PWoH]) who underwent an ultrasound, computed tomography, or magnetic resonance imaging between 2001-2017 were included. Patients with diagnosed cirrhosis or chronic viral hepatitis were excluded. SLD was defined by a natural language processing algorithm; primary outcome of composite of HCC or HD was defined using International Classification of Diseases 9/10 codes and national cancer registry. Follow-up began on imaging study date and continued until incident HCC/HD, death, or 31 December 2024. Adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs) of HCC/HD associated with SLD and HIV status were calculated.Results Among 19 546 patients (mean age: 54 years; 96.6% male; 28.6% PWH), 13 617 (69.7%) had SLD identified by natural language processing. Rates of HCC/HD were lowest in PWoH and no SLD (18.0/10 000 person-years) and highest among PWH and SLD (46.8/10 000 person-years). When compared to PWoH without SLD, risk of HCC/HD was increased among PWH with SLD (aHR: 2.71; 95% CI: 2.10-3.49) and PWH without SLD (aHR: 1.62; 95% CI: 1.14-2.29), although no interaction between HIV and SLD was observed (P = .25).Conclusions Among people without cirrhosis or chronic viral hepatitis, radiographic findings of SLD were associated with increased rates of HCC/HD, with the highest rate among PWH and SLD, independent of cardiometabolic factors, alcohol, and tobacco.
SN - 2328-8957
ER -