HIV and Liver transplantation: The British Columbia Experience, 2004 to 2013

Tan-Tam, Clara; Liao, Pamela; Montaner, Julio S. G.; Hull, Mark; Scudamore, Charles H.; Erb, Siegfried R.; Yoshida, Eric M.

doi:10.1155/2014/373898

Cited by 5 publications

(4 citation statements)

References 13 publications

(14 reference statements)

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“…This listing rate is similar to that reported by Tan‐Tam et al. (5/23 patients; 21.7%) in their retrospective study of HIV‐infected patients evaluated for LT in British Columbia, Canada.…”

Section: Discussionsupporting

confidence: 89%

“…In HIV‐infected patients, Tan‐Tam et al. reported 43.5% of their cohort died during the evaluation for LT and 17.4% of patients were considered too early.…”

Section: Discussionmentioning

confidence: 99%

“…To our knowledge, this is the largest study to identify factors associated with listing in HIV‐infected LT candidates. Of the previously published studies that evaluated LT listing in HIV‐infected patients, one focused on HBV, another used inclusion criteria different than those currently suggested in the United States, and the last analyzed outcomes in only 23 patients . As LT in HIV‐infected patients continues to evolve as a treatment option, a better understanding of the appropriate timing for LT and factors associated with LT are needed.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Clinical characteristics of human immunodeficiency virus patients being referred for liver transplant evaluation: a descriptive cohort study

Martel-Laferrière

Michel

Schaefer

et al. 2015

Transplant Infectious Dis

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Background Liver transplantation (LT) is a treatment option for select human immunodeficiency virus (HIV)-infected patients with advanced liver disease. The aim of this study was to describe LT evaluation outcomes in HIV-infected patients. Methods All HIV-infected patients referred for their first LT evaluation at the Mount Sinai Medical Center were included in this retrospective, descriptive cohort study. Multivariable logistic regression was used to identify factors independently associated with listing. Results From February 2000 and April 2012, 366 patients were evaluated for LT, with 66 (18.0%) listed for LT and 300 (82.0%) not listed. Fifty-one patients (13.9%) died before completing evaluation and 85 (23.2%) were too early for listing. Reasons patients were declined for listing were psychosocial (15.8%), HIV-related (10.4%), loss to follow up (9.6%), surgical/medical (6.0%), liver-related (4.4%), patient choice (3.4%), and financial (1.6%). Listed patients were more likely to have hepatocellular carcinoma (HCC) (43.1% vs. 17.1%; P <0.0001) and less likely to have hepatitis B (6.2% vs. 15.7%; P = 0.04) or a psychiatric history (19.7% vs. 35.2%; P = 0.02) than those not listed. In multivariable analysis, HCC (odds ratio [OR] 5.79; 95% confidence interval 2.97–11.28), MELD at referral (OR 1.06; 1.01–1.11), and hepatitis B (OR 0.26; 0.08–0.79) were associated with listing. Conclusion MELD score and HCC were positive predictors of listing in HIV-infected patients referred for LT evaluation and, therefore, timely referrals are vital in these patients. Because MELD is a predictor for death while undergoing an evaluation, a rapid evaluation should be performed in HIV-infected patients with a higher MELD score.

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Section: Discussionsupporting

confidence: 89%

“…In HIV‐infected patients, Tan‐Tam et al. reported 43.5% of their cohort died during the evaluation for LT and 17.4% of patients were considered too early.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Clinical characteristics of human immunodeficiency virus patients being referred for liver transplant evaluation: a descriptive cohort study

Martel-Laferrière

Michel

Schaefer

et al. 2015

Transplant Infectious Dis

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show abstract

“…Standard immunosuppressive therapy, such as steroids and azathioprine, is usually thought to be high-risk in already immunocompromised HIV patients. There are only two reported cases, where patient's condition improved with HAART alone [3, 7]. Prior retrospective case reports showed that standard AIH therapy was successful in well controlled HIV on HAART (CD4 >250 and undetectable HIV viral load).…”

Section: Discussionmentioning

confidence: 99%

Autoimmune Hepatitis (AIH) in Acquired Immune Deficiency Syndrome (AIDS): A Case Report and Review of Literature

Roussel

Pandit

Jordan

et al. 2019

Case Reports in Hepatology

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The common causes of abnormal liver chemistries in human immunodeficiency virus (HIV) infected patients are multifactorial. Diagnosis of autoimmune hepatitis (AIH) in HIV infected patients is intriguing but data is scarce. Unmasking of AIH during immune reconstitution in HIV patients after starting antiretroviral therapy is reported but not with advanced acquired immunodeficiency syndrome (AIDS). Here we present a fascinating case of 32-year-old African-American man with advanced AIDS who presented with elevated transaminases. He was diagnosed with AIH before starting antiretroviral therapy and successfully treated with prednisolone and azathioprine with antiretroviral therapy despite very low CD4 count.

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Kaleidoscope of autoimmune diseases in HIV infection

Roszkiewicz

Smolewska

2016

Rheumatol Int

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Within the last 30 years, the human immunodeficiency virus (HIV) infection has changed its status from inevitably fatal to chronic disorder with limited impact on life span. However, this breakthrough was mainly the effect of introduction of the aggressive antiviral treatment, which has led to the clinically significant increase in CD4+ cell count, resulting in fewer cases of the acquired immunodeficiency syndrome (AIDS) and improved management of opportunistic infections occurring in the course of the disease. The occurrence of a particular autoimmune disease depends on degree of immunosuppression of the HIV-positive patient. In 2002, four stages of autoimmunity were proposed in patients infected by HIV, based on the absolute CD4+ cell count, feature of AIDS as well as on the presence of autoimmune diseases. Spectrum of autoimmune diseases associated with HIV infection seems to be unexpectedly wide, involving several organs, such as lungs (sarcoidosis), thyroid gland (Graves' disease), liver (autoimmune hepatitis), connective tissue (systemic lupus erythematosus, rheumatoid arthritis, polyarteritis nodosa and other types of vasculitis, antiphospholipid syndrome) or hematopoietic system (autoimmune cytopenias). This paper contains the state of art on possible coincidences between HIV infection and a differential types of autoimmune diseases, including the potential mechanisms of this phenomenon. As the clinical manifestations of autoimmunization often mimic those inscribed in the course of HIV infection, health care providers should be aware of this rare but potentially deadly association and actively seek for its symptoms in their patients.

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HIV and Liver transplantation: The British Columbia Experience, 2004 to 2013

Cited by 5 publications

References 13 publications

Clinical characteristics of human immunodeficiency virus patients being referred for liver transplant evaluation: a descriptive cohort study

Clinical characteristics of human immunodeficiency virus patients being referred for liver transplant evaluation: a descriptive cohort study

Autoimmune Hepatitis (AIH) in Acquired Immune Deficiency Syndrome (AIDS): A Case Report and Review of Literature

Kaleidoscope of autoimmune diseases in HIV infection

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