Abstract
Human immunodeficiency virus (HIV) and hepatitis-B virus (HBV) infections are weighty public health challenges, especially in the African continent. The direct carcinogenic effect of HBV means that it remains a potent cause of early-onset hepatocellular carcinoma (HCC) in Sub-Saharan Africa (SSA), where it causes significant morbidity and mortality. The presence of HIV infection in HBV-infected patients poses a complicating factor, as coinfection has been shown to hasten the progression of liver disease to cirrhosis and HCC, and often resulting in early-age hepatocarcinogenesis with consequent late diagnosis and lower survival. In this review, we discuss this unique conundrum, the epidemiology of HIV-HBV coinfection in SSA, its effect on liver disease and development of HCC, as well as practices and barriers to HCC surveillance in this distinct population. We propose a way forward to curb this considerable health burden focusing on reduction of disease stigma, the need for easy-to-measure biomarkers, and implementation of large prospective studies in this population.
Original language | English (US) |
---|---|
Article number | 39 |
Journal | Hepatoma Research |
Volume | 8 |
DOIs | |
State | Published - 2022 |
Bibliographical note
Funding Information:Robert Wood Johnson Foundation (AFMDP), University of Minnesota AIRP, EU Horizon 2020 program (project number 825510), and NIH-NCI R21 CA215883-01A1 all to JDD.
Publisher Copyright:
© The Author(s) 2022.
Keywords
- HBV
- HIV
- Sub-Saharan Africa
- coinfection
- hepatocellular carcinoma
- surveillance