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

Sorafenib Therapy for Hepatocellular Carcinoma in an HIV–HCV Coinfected Patient: A Case Report

“…Routine screening facilitates earlier diagnosis, thereby allowing more effective application of curative medical and surgical interventions, such as resection or ablation. Even liver transplant, once thought unfeasible as a result of possible consequences of immune suppression therapy on HIV, can be an option for HIV patients who meet requirements for listing [16], although HCV reinfection remains an unresolved issue [17]. The clinical picture is complicated by concerns over hepatotoxicity and potential drug interactions associated with HAART [18].…”

Liver transplantation in human immunodeficiency virus-positive patients

“…68 Even though the HIV/HCV-coinfected patients were younger than the HCV-monoinfected patients at the time of transplantation (37 versus 42 years, P ¼ 0.05), they had poorer 1-and 3-year graft survival rates (71% and 59% versus 86% and 67%, P ¼ 0. 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.…”

“…cART intolerance post-LT, however, has been identified as an important predictor of survival. 47 A past, distant history of opportunistic infections is no longer a contraindication for LT unless there is no effective treatment for their possible recurrence after transplantation. Contraindications currently include multidrug-resistant HIV, resistant fungal infections, chronic intestinal cryptosporidiosis, progressive multifocal leukoencephalopathy, and lymphoma.…”

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

“…Dans l'expérience nord-américaine rapportée récem-ment, la survie, bien qu'inférieure, n'était pas significativement différente chez les patients co-infectés transplantés et chez les patients infectés VHC sans infection VIH transplantés pour cirrhose virale C ; la survie à 1 an, 3 ans et 5 ans était de 67 %, 56 % et de 33 % (p = 0,07) dans le groupe co-infecté et de 76 %, 72 % et de 72 % dans le groupe mono-infecté [25]. Dans une étude menée par le même groupe, la survie était influencée par la toxicité des antirétroviraux, un taux de CD4 après greffe inférieur à 200 cellules/μl et une charge virale VIH post-transplantation supérieure à 400 copies/ml [26].…”