De Novo Cancer in Liver Transplant Patients With HIV Infection: A Multicenter Nationwide Cohort Study

Patients with human immunodeficiency virus (HIV) infection have been gradually accepted as solid organ transplant recipients, although there is still concern that the burden of immunosuppression and HIV infection could increase the risk of post-transplant cancer.

The risk of de novo cancer was evaluated in a prospective cohort of 272 HIV-positive and 816 matched HIV-negative liver transplant recipients in Spain (2002-2012). All tumors, except hepatocellular carcinoma recurrence and non-melanoma skin cancer, after liver transplant were considered as events and death as competing event in this study.

Despite matching, patients with HIV were significantly younger (45.8 vs 49.3 years). Sixteen (5.9%) patients with HIV and 61 (7.5%) HIV-negative patients developed de novo cancers (P = .39) after a median follow-up of 59.8 and 72.3 months, respectively. The most frequently diagnosed types of tumors were non-Hodgkin lymphoma (n = 19), lung cancer (n = 14), and head and neck cancer (n = 14). Time of onset, distribution, and tumor stage at diagnosis were similar in both groups. The cumulative incidences of de novo cancer at 5 and 10 years were, respectively, 6% and 12% in patients with HIV and 6% and 13% in uninfected patients. Survival after cancer diagnosis did not differ between groups. The only factor related to the development of de novo cancers was a higher age at transplantation.

Human immunodeficiency virus infection per se is not associated to a higher risk of de novo cancer after liver transplantation.