Liver Transplantation in Adults Coinfected With Hiv

Abstract

The early outcome of liver transplantation in HIV seropositive patients can be good, and patients should not be excluded from transplantation if their liver disease determines their prognosis. More effective antiviral therapy for hepatitis C given posttransplantation, and for hepatitis B reinfection, should improve the longer-term outcome of HIV patients with end-stage liver disease due to hepatitis.

Orthotopic liver transplantation in patients with human immunodeficiency virus and end-stage liver disease

“…The rapid progression of HCV was a major concern because survival in this group of patients was between 6 and 25 months. 28 In abstract form at the Eighth Conference on Retroviruses and Opportunistic Infections in 2001, the King's group reported on 7 coinfected patients, 4 with HCV recurrence, and an overall survival between 3 and 25 months.…”

La transplantation hépatique chez les patients co-infectés VIH/VHC et VIH/VHB

“…Dans la période suivant la greffe, deux problèmes majeurs surviennent représentés d'une part par la toxicité des antirétroviraux, et d'autre part la récidive virale C sur le greffon (Tableau I) [14][15][16][17][18][19][20][21][22]. Récidive virale C : n = 6 (M49, M14, M9, M11, M13, M4) Récidive virale C et rejet chronique : n = 1 (M20) Défaillance multiviscérale : n = 2 (S1, S2) Récidive carcinome hépatocellulaire : n = 1 (M12) Sepsis : n = 3 (M2, M3, M6) Tableau I. Principales expériences de transplantation hépatique chez les patients co-infectés par le VIH dans la littérature.…”

The difficulty in timing for liver transplantation in cirrhotic patients coinfected with HIV: In search for a prognosis score

“…8,9 For these reasons, several centres in the world have developed a liver transplantation program for HIV-infected patients. [10][11][12][13][14] This new indication of liver transplantation raised several questions: What is the ideal timing for liver transplantation in HIV-HBV and HIV-HCV cirrhotic patients? What is the risk of HIV progression after liver transplantation?…”

“…12,14 The first reports have shown universal graft reinfection with HCV, a particular severe course of HCV graft infection in some patients, and a lower patient survival rate after transplantation than in monoinfected HCV patients. 10,14 Although this has not been clearly demonstrated, it seems that the HCV recurrence is more severe in HIV-HCV infected transplant patients than in monoinfected HCV transplant recipients. The severity of HCV recurrence seems to be related to a more rapid progression of fibrosis on the graft and to a higher rate of cholestatic hepatitis.…”