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Zusammenfassung: <jats:title>Abstract</jats:title> <jats:p>Background: Chronic inflammation caused by hepatitis B virus infection, hepatitis C virus infection, and/or heavy alcohol use can lead to fibrosis, cirrhosis, and eventually hepatocellular carcinoma (HCC). FIB-4 is an index score calculated from platelet count, alanine transaminase, aspartate transaminase, and age that predicts fibrosis and cirrhosis. We hypothesized that high FIB-4 would be associated with development of HCC in HIV-infected persons, who are at high risk due to high prevalence of viral hepatitis and alcohol consumption, and possibly due to HIV infection itself.</jats:p> <jats:p>Methods: Using proportional hazards models, we tested this hypothesis among 22,980 HIV-infected men from the Veterans Aging Cohort Study. We identified incident HCC cases from the Veterans Affairs Central Cancer Registry.</jats:p> <jats:p>Results: During follow-up, there were 112 incident HCC diagnoses. The age- and race/ethnic group-adjusted HR was 4.2 [95% confidence interval (CI), 2.4–7.4] for intermediate FIB-4 and 13.0 (95% CI, 7.2–23.4) for high FIB-4, compared with low FIB-4. After further adjustment for enrollment year, CD4 count, HIV-1 RNA level, antiretroviral therapy use, hepatitis B and C virus infection, alcohol abuse/dependency, and diabetes, FIB-4 remained a strong, significant, independent risk factor for HCC. The multivariate-adjusted HR was 3.6 (95% CI, 2.1–6.4) for intermediate FIB-4 and 9.6 (95% CI, 5.2–17.4) for high FIB-4.</jats:p> <jats:p>Conclusions: Calculated from routine, noninvasive laboratory tests, FIB-4 is a strong, independent HCC risk factor in HIV-infected patients.</jats:p> <jats:p>Impact: FIB-4 might prove valuable as an easily measured index to identify those at highest risk for HCC, even prior to development of clinical cirrhosis. Cancer Epidemiol Biomarkers Prev; 20(12); 2512–7. ©2011 AACR.</jats:p>
Umfang: 2512-2517
ISSN: 1055-9965
1538-7755
DOI: 10.1158/1055-9965.epi-11-0582