Imperial College London
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ProfessorRohiniSharma

Faculty of Medicine, Department of Surgery & Cancer

Professor Clinical Pharmacology and Medical Oncology
 
 
 
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Contact

 

+44 (0)20 3313 3059r.sharma Website

 
 
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Location

 

ICTEM buildingHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Pinato:2017:10.1111/apt.14356,
author = {Pinato, DJ and Sharma, R and Citti, C and Platt, H and Ventura-Cots, M and Allara, E and Chen, T-Y and Dalla, Pria A and Jain, M and Minguez, B and Kikuchi, L and West, EK and Merli, M and Kaplan, DE and Hasson, H and Marks, K and Nelson, M and Nunez, M and Aytaman, A and Bower, M and Brau, N},
doi = {10.1111/apt.14356},
journal = {Alimentary Pharmacology and Therapeutics},
pages = {95--103},
title = {The albumin-bilirubin grade uncovers the prognostic relationship between hepatic reserve and immune dysfunction in HIV-associated hepatocellular carcinoma},
url = {http://dx.doi.org/10.1111/apt.14356},
volume = {47},
year = {2017}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background:Hepatocellular carcinoma (HCC) is a leading cause of liver-related mortality in people living with HIV, where co-infection with hepatotropic viruses accelerates the course of chronic liver disease.Aim:To evaluate whether the albumin-bilirubin (ALBI) grade, a more accurate marker of liver dysfunction in HCC, might identify patients with progressive liver dysfunction in the context of HIV/hepatitis co-infection.Methods:Using uni- and multi-variable analyses, we studied the albumin-bilirubin grade as a predictor of overall survival (OS) in a large, multi-center cohort of patients with HIV-associated HCC recruited from 44 centres in 9 countries within the Liver Cancer in HIV study group. Patients who underwent liver transplantation were excluded.Results:A total of 387 patients, predominantly HCV co-infected (78%) with balanced representation of all Barcelona Clinic Liver Cancer (BCLC) stages (A = 33%, B = 18%, C = 37%, D = 12%) were recruited. At HCC diagnosis, 84% had been on anti-retrovirals for a median duration of 8.8 years. The albumin-bilirubin grade identified significant differences in median survival of 97 months for grade 1 (95% CI 13-180 months), 17 months for grade 2 (95% CI 11-22 months) and 6 months for grade 3 (95% CI 4-9 months, P < .001). A more advanced albumin-bilirubin grade correlated with lower CD4 counts (464/373/288 cells/mm3 for grades 1/2/3) and higher HIV viraemia (3.337/8.701/61.845 copies/mL for grades 1/2/3, P < .001).Conclusions:In this large, multi-center retrospective study, the albumin-bilirubin grade highlights the interplay between liver reserve and immune dysfunction as prognostic determinants in HIV-associated HCC.
AU  - Pinato,DJ
AU  - Sharma,R
AU  - Citti,C
AU  - Platt,H
AU  - Ventura-Cots,M
AU  - Allara,E
AU  - Chen,T-Y
AU  - Dalla,Pria A
AU  - Jain,M
AU  - Minguez,B
AU  - Kikuchi,L
AU  - West,EK
AU  - Merli,M
AU  - Kaplan,DE
AU  - Hasson,H
AU  - Marks,K
AU  - Nelson,M
AU  - Nunez,M
AU  - Aytaman,A
AU  - Bower,M
AU  - Brau,N
DO  - 10.1111/apt.14356
EP  - 103
PY  - 2017///
SN  - 0269-2813
SP  - 95
TI  - The albumin-bilirubin grade uncovers the prognostic relationship between hepatic reserve and immune dysfunction in HIV-associated hepatocellular carcinoma
T2  - Alimentary Pharmacology and Therapeutics
UR  - http://dx.doi.org/10.1111/apt.14356
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000417649400011&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - http://hdl.handle.net/10044/1/57411
VL  - 47
ER  -
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