July 9, 2012

Outcome of HCV/HIV-Coinfected Liver Transplant Recipients: A Prospective and Multicenter Cohort Study


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The life expectancy of HIV positive persons has improved considerably in the past decade. Several countries are now performing kidney and liver transplants in HIV infected recipients. One of the leading indications for liver transplant in HIV patients is Hepatitis C. This study from Spain examines whether outcomes are similar in HCV/HIV coinfected patients as compared to HCV only infected patients. Although one year survival was comparable in the two groups, 5-year survival was lower in the coinfected patients. Significant pre-transplant variables that predicted post-transplant mortality were transplantation with a high plasma HCV viral load, MELD score, and having a transplant in a center that performed <1 liver transplant in HIV-infected patients per year. The authors also examined peri-transplant and post-transplant predictors of mortality in the coinfected cohort. When compared to HCV monoinfection, coinfected patients had a greater risk of acute rejection. Selection of patients is key to patient and graft survival and this study sheds light on possible variables during the evaluation of the transplant candidate that are important.

Liver Transplantation, Transplant Infectious Disease

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