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Liver transplantation in HIV-HCV coinfected patients: a case-control study
Authors:Castells Lluis  Escartín Alfredo  Bilbao Itxarone  Len Oscar  Allende Helena  Vargas Víctor  Ribera Esteban  Lázaro José-Luis  Bueno Javier  Balsells Joaquin  Esteban Rafael  Pahissa Albert  Margarit Carlos
Affiliation:Liver Unit, Department of Internal Medicine, Hospital Universitari Vall d'Hebrón, Universidad Autónoma de Barcelona, Barcelona, Spain.
Abstract:Liver transplantation (LT) for hepatitis C virus (HCV)-associated cirrhosis in human immunodeficiency virus (HIV)-infected patients was compared with non-HIV patients. Nine patients with HIV-HCV coinfection were compared with patients transplanted before and after each HIV patient (control group). Immunosuppression consisted in tacrolimus with steroids or mycophenolate mofetil. Acute cellular rejection and three-year actuarial patient survival were respectively 44% and 87.5% in HIV group and 22% and 93.7% in the control group (P=NS). Acute hepatitis C virus occurred earlier (2.3 vs. 4.3 months) and was more cholestatic (mean bilirubin: 10.8 vs. 1.6 mg/dL) in the HIV group. Eight (100%) HIV and nine (64.3%) control patients received antiviral treatment with pegylated interferon and ribavirin. One patient (11.1%) of the control group and one patient (20%) of the HIV group presented a sustained virologic response (P=NS). Short- to midterm results of LT in HIV-HCV co-infected patients were excellent and similar to non-HIV patients.
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