Editor’s Note: Individuals living with HIV are at a higher risk of developing hepatocellular carcinoma (HCC) due to immune system impairment and often face poorer prognoses. At the ongoing 2024 IDWeek Conference, Dr. Hua You from the Children’s Hospital of Chongqing Medical University presented a groundbreaking study on the development of the first-ever prognostic model tailored for HIV-infected HCC patients—the HIHP model. Demonstrating remarkable performance in both internal and external validation, this model offers promising new directions for the treatment and prognosis of HIV-infected HCC patients.

Research Overview

Study Title: A Clinical Prognostic Risk Stratification System for HIV-Infected Hepatocellular Carcinoma Patients (Abstract #467)

Background

HIV infection predisposes patients to hepatocellular carcinoma due to immune dysfunction, creating an urgent need for specific prognostic models. Traditional HCC prognostic models have shown limited accuracy in predicting outcomes for HIV-positive HCC patients.

Study Design

• Participants: Training and Validation Cohorts: 85 HIV-positive HCC patients from Guangzhou Eighth People’s Hospital, divided into training (n=60) and internal validation (n=25) cohorts. External Validation Cohorts: 23 HIV-positive HCC patients from the Second Affiliated Hospital of Southern University of Science and Technology. 275 HIV-negative HCC patients from the Cancer Hospital of Guangzhou Medical University.
• Model Development: The HIHP model incorporated two independent OS-related prognostic factors identified from the training cohort. The model was tested against traditional HIV-negative HCC prognostic scoring systems to assess its accuracy.

Key Findings

1. Performance in Training and Validation Cohorts: The HIHP model effectively stratified HIV-positive HCC patients into low-, medium-, and high-risk groups, with median OS of 13, 7, and 3 months, respectively (P<0.001). Internal and external validation confirmed the model’s robustness in predicting OS across HIV-positive cohorts.
2. Comparison with Traditional Models: Traditional HIV-negative HCC prognostic systems failed to stratify HIV-positive HCC patients effectively. The HIHP model showed no advantage in predicting outcomes for HIV-negative HCC patients, underscoring its specificity.

Clinical Implications

This novel model addresses the limitations of existing prognostic tools by providing accurate OS predictions for HIV-positive HCC patients. Its utility in guiding clinical decision-making could improve survival outcomes for this vulnerable population. However, the model is not applicable to HIV-negative HCC patients, indicating a need for tailored approaches for different patient subsets.

Researcher’s Perspective

Dr. Hua You highlighted the clinical significance of this study:

“Our model represents a breakthrough in the prognostic evaluation of HIV-positive HCC patients. By accurately stratifying risk and predicting survival, it offers a valuable tool for clinicians to monitor outcomes and refine treatment strategies. We hope this innovation will ultimately enhance survival rates in this high-risk group.”

Acknowledgments

This study was made possible through collaboration with Guangzhou Eighth People’s Hospital and Shenzhen Third People’s Hospital. Special thanks were extended to Dr. He Haolan and Dr. Zhao Han from Guangzhou Eighth People’s Hospital, and Dr. Zhao Dong from Shenzhen Third People’s Hospital.