HIV, Viral Hepatitis, and Schistosomiasis Association with Liver Cancer: A Systematic Review

Liver cancer is a notable global health concern, with several infections contributing to its etiology. This systematic review investigates the roles of HIV, viral hepatitis, and schistosomiasis in the development of liver cancer, particularly hepatocellular carcinoma. This systematic review was registered under PROSPERO with the reference: CRD42024566941. A comprehensive literature search was conducted using various databases (PubMed, ScienceDirect, Google Scholar, Scopus, and Web of Science) to identify studies examining the association between HIV, viral hepatitis, and schistosomiasis with hepatocellular carcinoma. The inclusion criteria were studies published in English between the years 2000 and 2025 that primarily explored the association and process through which HIV, viral hepatitis, and schistosomiasis trigger hepatocarcinogenesis. Data retrieval and quality assessment were conducted independently by all co-authors. Overall, 31 studies were deemed relevant to this systematic review. Findings indicate that HIV-associated immunosuppression significantly increases the risk of HCC, with one study reporting a 70% increased incidence among its cohort, and another study noting an 87% increase in HCC-related mortality. Among viral hepatitis cases, one study reported that 86% of HCC infections were attributed to HBV, while HCV genotype 3 was associated with a 68.8% mortality rate in HCC patients. For schistosomiasis, a study showed that 8.1% of schistosomiasis patients with portal vein thrombosis developed HCC. No studies were identified on the association of liver cancer with simultaneous multi-infection by HIV, viral hepatitis, and schistosomiasis. These results underscore the necessity for targeted interventions and integrated strategies to prevent and treat single and concurrent infections that could accelerate infection-associated liver cancer.