Related Experiment Video
Updated: Feb 22, 2026
Author Spotlight: Investigating Immune Cell Dynamics in the Tumor Microenvironment — Challenges and Innovations in Cancer Prognosis
Published on: April 12, 2024
Systemic Inflammatory Response Is a Prognostic Marker in HIV-Infected Patients with Hepatocellular Carcinoma
David J Pinato1, Marco Merli, Alessia Dalla Pria
1Department of Surgery and Cancer, Hammersmith Campus of Imperial College London, London, UK.
Insights
Systemic inflammation, indicated by a high neutrophil to lymphocyte ratio (NLR), independently predicts survival in HIV-associated hepatocellular carcinoma (HCC). This marker correlates with advanced cancer stage and poor performance status, not HIV severity.
Area of Science:
- Hepatology
- Oncology
- Immunology
Background:
- Hepatocellular carcinoma (HCC) is a growing concern in individuals with HIV.
- Systemic inflammation is a potential prognostic factor in HIV-associated HCC that needs further validation.
Purpose of the Study:
- To investigate the prognostic significance of inflammatory markers, specifically the neutrophil to lymphocyte ratio (NLR), in HIV-associated HCC.
- To analyze the correlation between NLR and clinical/pathological features in this patient cohort.
Main Methods:
- Utilized a multi-center database of consecutive HCC cases.
- Performed univariate and multivariate survival analyses to assess the prognostic role of inflammatory markers.
- Included neutrophil to lymphocyte ratio (NLR) as a key inflammatory marker.
Main Results:
- Identified 59 patients with HIV-associated HCC, primarily due to hepatitis C (69%) or B virus (32%).
- Median survival was 22 months.
- An elevated NLR was an independent predictor of survival, associated with advanced Barcelona Clinic Liver Cancer stage and poor performance status, but not HIV RNA or CD4 counts.
Conclusions:
- Systemic inflammation, measured by NLR, is a prognostic determinant in HIV-associated HCC.
- NLR is linked to adverse pathological features of malignancy, independent of HIV status.
- The findings suggest a potential tumor-promoting role of the innate immune response, meriting further mechanistic research.
Background:
Hepatocellular carcinoma (HCC) is increasingly prevalent in people living with HIV. Systemic inflammation is a prognostic factor requiring validation in HIV-associated HCC.
Aims:
Using a multi-centre database of consecutive HCC cases, we investigated the prognostic role of a panel of inflammatory markers, including neutrophil to lymphocyte ratio (NLR), using univariate and multivariate survival analyses.
Results:
Fifty-nine patients with HIV-associated HCC secondary to hepatitis C (69%) or B virus infection (32%) were identified. The median survival was 22 months. A raised NLR independently predicted patients' survival and was correlated with advanced Barcelona Clinic Liver Cancer stage (p = 0.003) and poor performance status (p < 0.001) but not with HIV RNA or CD4 counts.
Conclusion:
Systemic inflammation, as measured by NLR, is a prognostic determinant associated with adverse pathological features of malignancy, but not coexisting HIV infection, suggesting a tumour-promoting role of the innate immune response that warrants further investigation in mechanistic studies.
