Outcomes of liver transplantation in HIV-infected individuals: The impact of HCV and HBV infection

Norris, Suzanne; Taylor, Chris; Muiesan, Paolo; Portmann, Bernard; Knisely, A. S.; Bowles, Matthew; Rela, Mohamed; Heaton, Nigel; O’Grady, John

doi:10.1002/lt.20233

Cited by 85 publications

(93 citation statements)

References 49 publications

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“…Additionally, fibrosis-free survival rates were markedly low in co-infected patients after the second year post-transplant, whereas the majority of mono-infected patients only experienced mild recurrent hepatitis. These results are similar to our series, in which 5 of 7 HCVinfected patients died after LT at 95-784 d (median 161 d), of whom 4 patients died of recurrent HCV infection and sepsis, despite antiviral therapy in 3 [69] . Longer followup in larger series is required before a conclusive directive can be provided for HCV/HIV co-infected patients requiring LT and the advent of more effective anti-viral therapy may transform the outlook for this group.…”

Section: Hcv Positive Donors and Co-infectionssupporting

confidence: 90%

Strategies to reduce hepatitis C virus recurrence after liver transplantation

Ciria

Pleguezuelo²,

Khorsandi³

et al. 2013

WJH

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Hepatitis C virus (HCV) is a major health problem that leads to chronic hepatitis, cirrhosis and hepatocellular carcinoma, being the most frequent indication for liver transplantation in several countries. Unfortunately, HCV re-infects the liver graft almost invariably following reperfusion, with an accelerated history of recurrence, leading to 10%-30% of patients progressing to cirrhosis within 5 years of transplantation. In this sense, some groups have even advocated for not retransplanting this patients, as lower patient and graft outcomes have been reported. However, the management of HCV recurrence is being optimized and several strategies to reduce post-transplant recurrence could improve outcomes, decrease the rate of re-transplantation and optimize the use of available grafts. Three moments may be the focus of potential actions in order to decrease the impact of viral recurrence: the pretransplant moment, the transplant environment and the post-transplant management. In the pre-transplant setting, it is not well established if reducing the pre transplant viral load affects the risk for HCV progression after transplant. Obviously, antiviral treatment can render the patient HCV RNA negative post transplant but the long-term benefit has not yet been fully established to justify the cost and clinical risk. In the transplant moment, factors as donor age, cold ischemia time, graft steatosis and ischemia/reperfusion injury may lead to a higher and more aggressive viral recurrence. After the transplant, discussion about immunosuppression and the moment to start the treatment (prophylactic, pre-emptive or once-confirmed) together with new antiviral drugs are of interest. This review aims to help clinicians have a global overview of posttransplant HCV recurrence and strategies to reduce its impact on our patients.

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Section: Hcv Positive Donors and Co-infectionssupporting

confidence: 90%

Strategies to reduce hepatitis C virus recurrence after liver transplantation

Ciria

Pleguezuelo²,

Khorsandi³

et al. 2013

WJH

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“…(9,11,12). Our current experience does indicate that HCV recurrence is a significant cause of graft loss and patient mortality in these patients.…”

Section: Discussionmentioning

confidence: 83%

“…Several series have demonstrated comparable patient and graft survival after LTx between HIV-negative recipients and HIV patients with HBV cirrhosis, drug-induced liver failure and fulminant liver failure (7)(8)(9)(10)(11). However, some have reported poor outcomes in the transplantation of coinfected HIV and HCV patients (9,11,12).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Survival of Liver Transplant Patients Coinfected with HIV and HCV Is Adversely Impacted by Recurrent Hepatitis C

Vera¹,

Dvorchik²,

Tom³

et al. 2006

American Journal of Transplantation

138

130

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“…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.…”

Section: Les Aspects Particuliers De La Transplantation Hépatique Cheunclassified

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

et al. 2007

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Les infections par le virus de l'hépatite C (VHC) et le virus de l'immunodéficience humaine (VIH) sont des problè-mes de santé publique majeurs. Plus de 40 millions de personnes sont infectés par le VIH dans le monde, et 2 % à 3 % de la population sont infectés par le virus de l'hépatite C soit environ 175 millions de personnes. Dix millions d'individus sont co-infectés par le VIH et le VHC. La transmission de l'infection par le VHC, comme celle du VIH, s'effectue majoritairement par voie parentérale. Ainsi la co-infection VIH/VHC est volontiers fréquente dans la population toxicomane et celle des hémophiles. Une infection par le virus de l'hépatite C est présente chez 70 % à 90 % de la population hémophile et 60 % à 80 % de la population toxicomane.

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Outcomes of liver transplantation in HIV-infected individuals: The impact of HCV and HBV infection

Cited by 85 publications

References 49 publications

Strategies to reduce hepatitis C virus recurrence after liver transplantation

Strategies to reduce hepatitis C virus recurrence after liver transplantation

Survival of Liver Transplant Patients Coinfected with HIV and HCV Is Adversely Impacted by Recurrent Hepatitis C

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

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