New entities in the treatment of hepatocellular carcinoma: HIV-positive and elderly patients

The hepatocellular carcinoma (HCC) is the most common primary cancer of the liver and, according to the WHO report, the fourth commonest cause of death. The estimated incidence of new cases worldwide is about 500,000-1,000,000 per year, causing 600,000 deaths globally per year. The incidence of HCC has been rising in developed western countries in the last two decades, along with the emergence of hepatitis C virus infection and to the rise of immigration rates from HBV-endemic countries. In addition, even though the incidence of HCC reaches its highest peak among persons over 65 years, an increased incidence among younger individuals has been noted in the last two decades both in USA and Europe. In the last decades two kinds of HCC patients are more interesting, for clinical characteristics, than typical patients with HCC: elderly and HIV-positive patients. In fact due to the increase of the life expectancy in many countries, HCC represents a new challenge in this particular setting of patients.