Over a third of HIV-positive people with hepatitis C virus-related liver cirrhosis are not having regular ultrasound examinations to check for possible liver cancer, Canadian research published in Clinical Infectious Diseases shows. Two patients diagnosed with hepatocellular carcinoma (HCC, liver cancer) did not have ultrasound screens.
Patients receiving care at centres with standardised systems for screening were significantly more likely to have an abdominal ultrasound.
“Patient care protocols with automated reminders may be a particularly effective means of ensuring compliance with screening,” suggest the investigators.
There is a high prevalence of hepatitis C virus (HCV) co-infection among people with HIV. Liver disease is now an important cause of death in these individuals. An ever-increasing proportion of these deaths is caused by HCC.
Guidelines in Canada, Europe and the United States recommend that people with HCV-related liver cirrhosis should be screened every six to twelve months for HCC using abdominal ultrasounds.
Canadian investigators caring for people co-infected with HIV and HCV wanted to see if this guidance was being followed. They therefore designed a prospective study involving co-infected adult patients with confirmed or possible liver cirrhosis who received care at 16 centres across Canada between 2003 and 2012. Research personnel collected information on whether an abdominal ultrasound was done for each patient. The investigators examined the participants’ demographic data and clinical records to see if any factors were associated with an increased chance of having ultrasound investigations.
