Vincent Lo Re, MD, MSCE, Assistant Professor of Medicine in the Division of Infectious Diseases and Epidemiology at the Perelman School of Medicine at the University of Pennsylvania, and Amy Justice, MD, PhD, Professor of General Medicine and Public Health at Yale School of Public Health, have been awarded a $3 million grant from the National Cancer Institute (NCI) to study possible links between liver cancer and human immunodeficiency virus (HIV).
Vincent Lo Re, MD, MSCE
Amy Justice, MD, PhD
The project will investigate liver cancer among HIV-infected and uninfected veterans. People infected with HIV are about five times more likely to be diagnosed with liver cancer than uninfected people (and significantly more likely to be diagnosed with other types of cancer as well). As HIV-infected patients age, liver cancer–related deaths are expected to increase over time.
“Infection with HIV in general weakens the immune system and reduces the body’s ability to fight cancer and other diseases,” said Dr. Lo Re. “Our aim is to provide information on how the biology of aging and HIV interact to promote liver cancer. These results could inform future interventions to decrease the incidence of liver cancer.”
Drs. Lo Re and Justice, along with their research team, will use stored clinical biopsies from HIV-infected and uninfected veterans to determine whether liver cancer operates differently in HIV-infected individuals because of their diminished immune function and higher levels of inflammation.
Research Challenges
Despite the fivefold greater prevalence of liver cancer in HIV-infected patients, factors associated with its development in these patients remain largely unknown. Small numbers of liver cancer cases; short follow-up; inclusion of demographically different uninfected comparison groups; lack of inclusion of established risk factors for liver cancer; and concerns about generalizability to HIV-infected patients have limited previous studies of liver cancer in HIV-infected patients.
The project (grant number R01-CA206465) will address these knowledge gaps and limitations by merging over 15 years of electronic medical record data from HIV-infected and demographically similar uninfected patients in the Veterans Aging Cohort Study, the largest HIV cohort in North America, with liver cancer tissue specimens from these individuals. ■
