Survival and recurrence of hepatitis C after liver transplantation in patients coinfected with human immunodeficiency virus and hepatitis C virus

Duclos‐Vallée, Jean‐Charles; Féray, Cyrille; Sebagh, Mylène; Teicher, Elina; Roque–Afonso, Anne–Marie; Roche, Bruno; Azoulay, Daniel; Adam, René; Bismuth, H; Castaing, Denis; Vittecoq, D.; Samuel, Didier

doi:10.1002/hep.21990

Cited by 178 publications

(228 citation statements)

References 35 publications

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“…134,135 FCH and sepsis are the leading causes of death in HCV and HIV coinfected patients. [136][137][138] With the availability of DAA for the treatment of recurrent HCV following liver transplantation, SVR rates have improved in HCV and HIV coinfected patients. 139,140 The indications for liver transplantation in HCV and HIV coinfected patients are similar to those for noninfected patients.…”

Section: Management Of Hcv In Hiv Coinfectionmentioning

confidence: 99%

Indian National Association for Study of the Liver (INASL) Guidance for Antiviral Therapy Against HCV Infection: Update 2016

Puri

Saraswat

Dhiman

et al. 2016

Journal of Clinical and Experimental Hepatology

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India contributes significantly to the global burden of HCV. While the nucleoside NS5B inhibitor sofosbuvir became available in the Indian market in March 2015, the other directly acting agents (DAAs), Ledipasvir and Daclatasvir, have only recently become available in the India. The introduction of these DAA in India at a relatively affordable price has led to great optimism about prospects of cure for these patients as not only will they provide higher efficacy, but combination DAAs as all-oral regimen will result in lower side effects than were seen with pegylated interferon alfa and ribavirin therapy. Availability of these newer DAAs has necessitated revision of INASL guidelines for the treatment of HCV published in 2015. Current considerations for the treatment of HCV in India include the poorer response of genotype 3, nonavailability of many of the DAAs recommended by other guidelines and the cost of therapy. The availability of combination DAA therapy has simplified therapy of HCV with decreased reliance of evaluation for monitoring viral kinetics or drug related side effects. ( J CLIN EXP HEPATOL 2016;6:119-145) T here have been revolutionary changes in the management of chronic hepatitis C (CH-C) over the last few years. Pegylated interferon alfa (Peg-IFNa) plus ribavirin (RBV) therapy, which till the recent past was the standard of care, has been eclipsed by the arrival of newer directly acting antiviral agents (DAAs). Not only do the DAAs have better efficacy, they are also associated with lower side effects, have better tolerability, a shorter duration of therapy, and have simpler administration.In the recent guidelines issued by the American Association for the study of Liver Diseases (AASLD), in collaboration with the Infectious Diseases Society of America 1 and the European Association for Study of the Liver z (EASL), 2 the role of Peg-IFNa/RBV therapy in the management of HCV has been relegated to second-line, backup status. These newer guidelines, however, cannot be implemented in India as many of the recommended drugs are yet to be marketed in India. Other considerations for the treatment of HCV in India are a predominance of

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Section: Management Of Hcv In Hiv Coinfectionmentioning

confidence: 99%

Indian National Association for Study of the Liver (INASL) Guidance for Antiviral Therapy Against HCV Infection: Update 2016

Puri

Saraswat

Dhiman

et al. 2016

Journal of Clinical and Experimental Hepatology

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“…47 The frequency of ACR in HIV/HCV-coinfected patients (31%) in the postoperative period appears to be comparable to the frequency in HCV-monoinfected patients (27%). 66 HCV recurrence after LT is universal, although a more accelerated disease course has been noted in patients coinfected with HIV. 66,69 HCV recurrence, particularly the aggressive, severe cholestatic form and sepsis are the leading causes of death post-LT in HIV/HCV-coinfected patients.…”

Section: Hepatitis C Coinfectionmentioning

confidence: 99%

“…66 HCV recurrence after LT is universal, although a more accelerated disease course has been noted in patients coinfected with HIV. 66,69 HCV recurrence, particularly the aggressive, severe cholestatic form and sepsis are the leading causes of death post-LT in HIV/HCV-coinfected patients. [64][65][66][70][71][72] Reassuringly, sepsis does not seem to be opportunistic in nature.…”

Section: Hepatitis C Coinfectionmentioning

confidence: 99%

“…66,69 HCV recurrence, particularly the aggressive, severe cholestatic form and sepsis are the leading causes of death post-LT in HIV/HCV-coinfected patients. [64][65][66][70][71][72] Reassuringly, sepsis does not seem to be opportunistic in nature. In a French study of 35 HIV/HCV-coinfected patients, the fibrosis scores were significantly higher than those of HCV-monoinfected patients 24 months post-LT (2.4 versus 1.4, P ¼ 0.01).…”

Section: Hepatitis C Coinfectionmentioning

confidence: 99%

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Liver transplantation in human immunodeficiency virus-positive patients

et al. 2011

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“…In agreement with our North American colleagues, we believe that the key to successful LT in an HIV setting depends on the accurate selection of patients and donors and the intensive management of drug interactions to prevent acute rejection. 2,3 …”

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confidence: 99%

Is liver transplantation feasible in patients coinfected with human immunodeficiency virus and hepatitis C virus?

et al. 2012

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TO THE EDITORS:We read with interest the article by Terrault et al. 1 recently published in Liver Transplantation. The authors prospectively described a series of human immunodeficiency virus (HIV)-infected patients undergoing liver transplantation (LT) at several US centers, and they reported lower survival rates for patients coinfected with HIV and hepatitis C virus (HCV) versus patients infected with HCV alone. The 3-year patient survival rates were 60% [95% confidence interval (CI) ¼ 47%-71%] for HCV/HIV-coinfected recipients and 79% (95% CI ¼ 72%-84%) for HCVinfected recipients (P < 0.001). HIV infection was the only factor significantly associated with reduced patient and graft survival. Among HCV/HIV-coinfected patients, an older donor age [hazard ratio (HR) ¼ 1.3 per decade], combined kidney-liver transplantation (HR ¼ 3.8), an HCV-positive donor (HR ¼ 2.5), and a body mass index less than 21 kg/m 2 (HR ¼ 3.2) were independent predictors of graft loss. The 3-year incidence of treated acute rejection was 1.6-fold higher for HCV/HIV-coinfected patients versus HCVmonoinfected patients (P ¼ 0.02), but the cumulative rates of severe HCV disease (29% versus 23% at 3 years) were not significantly different (P ¼ 0.21). The authors concluded that HCV per se is not a contraindication for LT in patients with HIV, but the selection of recipients and donors and the management of acute rejection strongly influence outcomes.We would like to comment on the results of Terrault et al. 1 and report the outcomes of 32 consecutive HIVinfected patients undergoing LT at our center in Udine, Italy (2004-2010. This study protocol was approved by the institutional review committee of the Italian National Transplant Center. The characteristics of these patients are shown in Table 1. The listing criteria were (1) no history of acquired immune deficiency syndrome (ie, illness in the previous 2 years), (2) a stable CD4 count > 200 cells/mL in the previous 6 months (or a count > 100 cells/mL if the patient was intolerant of highly active antiretroviral therapy because of hepatic toxicity), and (3) undetectable HIV RNA (in the case of current highly active antiretroviral therapy). Twenty-six patients (81%) were HIV/HCVcoinfected. The patients were followed up for a median of 2.89 years [interquartile range (IQR) ¼ 2.88-4.13 years, range ¼ 0-6.2 years], and there were 7 deaths (21.9%) over a cumulative follow-up time of 86.7 years. The estimated survival rates were 83.1% (95% CI ¼ 79.8%-99.5%) at 3 years and 69.8% (95% CI ¼ 63.7%-92.6%) at 5 years for the entire cohort. The estimated 3-and 5-year survival rates were 78.6% (95% CI ¼ 55.4%-90.6%) and 68.8% (95% CI ¼ 39.6%-85.9%) for HIV/HCV-coinfected patients and 100% (95% CI ¼ not applicable) and 75% (95% CI ¼ 12.8%-96.1%) for HIVmonoinfected patients. According to a univariate Cox regression analysis, only a pre-LT CD4 cell count nadir < 100 cells/mm 3 was a risk factor for death (HR ¼ 5.25, 95% CI ¼ 1.17-23.53, P ¼ 0.03). Biopsy-proven acute rejection was diagnosed in only 2 cases (6....

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Survival and recurrence of hepatitis C after liver transplantation in patients coinfected with human immunodeficiency virus and hepatitis C virus

Cited by 178 publications

References 35 publications

Indian National Association for Study of the Liver (INASL) Guidance for Antiviral Therapy Against HCV Infection: Update 2016

Indian National Association for Study of the Liver (INASL) Guidance for Antiviral Therapy Against HCV Infection: Update 2016

Liver transplantation in human immunodeficiency virus-positive patients

Is liver transplantation feasible in patients coinfected with human immunodeficiency virus and hepatitis C virus?

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