Hepatocellular carcinoma in HIV patients treated by liver transplantation

F. Di Benedetto, N. De Ruvo, M. Berretta, M. Masetti, R. Montalti, S. Di Sandro, R. Ballarin, M. Codeluppi, G. Guaraldi, G. E. Gerunda

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: Several reports have shown the effectiveness of liver transplantation (LT) as a therapeutic option in HIV-patients affected by end-stage liver disease. HCC on cirrhosis is another major indication for LT. However, no reports, to our knowledge, have been published as yet addressing the important questions of indications and outcome of LT in HIV-patients with HCC, mainly because of concerns regarding a more aggressive course of HCC with respect to HCC seen in HIV-negative individuals. Methods: The aim of this report is to focus on indications, preliminary results and complications of LT in a group of 7 HIV-patients who underwent LT at our department for HCC on cirrhosis. Results: Indications to listing HIV-patients were HCC using the internationally accepted Milan criteria. All patients were HBV-and/or HCV-infected. The mean CD4+ cell-count was 249 (range 144-353), and the HIV-RNA load was undetectable in all but one case. After a mean follow-up period of 232 days (range 33-774), no recurrence of HCC was seen; one patient died. Conclusion: Characteristics of the study protocol, the patients, virological and immunological features, tumor stage and pre-transplantation treatment, complications and survival are herein described in an effort to provide new insights into methodology for an aggressive management of HCC in HIV patients, and possibly give a greater chance of cure.

Original languageEnglish
Pages (from-to)422-427
Number of pages6
JournalEuropean Journal of Surgical Oncology
Volume34
Issue number4
DOIs
Publication statusPublished - Apr 2008

Keywords

  • CD4 cell count
  • HAART
  • Hepatocellular carcinoma
  • HIV positive patients
  • HIV viral load
  • Liver transplantation

ASJC Scopus subject areas

  • Oncology
  • Surgery

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