Role of liver transplantation in human immunodeficiency virus positive patients |
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Authors: | Deepak Joshi Kosh Agarwal |
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Affiliation: | Deepak Joshi, Kosh Agarwal, Institute of Liver Studies, King’s College Hospital NHS Foundation Trust, Denmark Hill, SE5 9RS London, United Kingdom |
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Abstract: | End-stage liver disease(ESLD) is a leading cause of morbidity and mortality amongst human immunodeficiency virus(HIV)-positive individuals. Chronic hepatitis B and hepatitis C virus(HCV) infection,drug-induced hepatotoxicity related to combined antiretro-viral therapy,alcohol related liver disease and non-alcohol related fatty liver disease appear to be the leading causes. It is therefore,anticipated that more HIV-positive patients with ESLD will present as potential transplant candidates. HIV infection is no longer a contraindication to liver transplantation. Key transplantation outcomes such as rejection and infection rates as well as medium term graft and patient survival match those seen in the non-HIV infected patients in the absence of co-existing HCV infection. HIV disease does not seem to be negatively impacted by transplantation. However,HIV-HCV coinfection transplant outcomes remain suboptimal due to recurrence. In this article,we review the key challenges faced by this patient cohort in the pre- and posttransplant period. |
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Keywords: | Hepatitis B virus Hepatitis C virus Human immunodeficiency virus Liver transplantation |
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