Liver Transplantation in HIV-Positive Patients

G. Vennarecci, G. M. Ettorre, M. Antonini, R. Santoro, L. Perracchio, G. Visco, E. Santoro

Research output: Contribution to journalArticle

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Abstract

Aims: The aim of this study was to evaluate the feasibility of liver transplantation (OLT) in human immunodeficiency virus (HIV), hepatitis C virus (HCV) coinfected patients in Italy. Methods: Between September 2002 and April 2006, 12 HIV+ coinfected patients (11 men, mean age 42 years) underwent OLT at our Institute. Eleven (91%) patients were HCV-positive and one was hepatitis B virus-positive. Pre-OLT plasma HIV 1-RNA level was undetectable and CD4+ T-cell count >200 cells/μL for 3 months in all patients. Six patients had to stop highly active antiretroviral therapy (HAART) before OLT because of liver disease severity (n = 2) and for hepato cellular carcinoma (n = 4). Results: The actuarial 1-, 2-, and 3-year survival rates were 83.3%, 58.3%, and 58.3%, respectively, which were significantly lower than those observed among HIV-negative patients transplanted in our center. Six patients are alive with a mean follow-up of 26 months (range: 5 to 46 months). We recorded a low rate of opportunistic infections and rejection. All alive patients have low levels of HIV RNA, and the CD4+ T-cell counts increased after OLT. Nine patients developed early recurrence of hepatitis C requiring combination therapy with peg-interferon plus ribavirin. Significant improvement in the quality of life was observed in 7/11 patients. Conclusions: OLT in HIV-positive patients was feasible with good results in the short and medium term. Early severe HCV recurrence may be observed. Key challenges for the management of HIV+ patients after transplantation included treatment of severe HCV recurrence and attention to the pharmacological interactions of HAART with immunosuppressive drugs.

Original languageEnglish
Pages (from-to)1936-1938
Number of pages3
JournalTransplantation Proceedings
Volume39
Issue number6
DOIs
Publication statusPublished - Jul 2007

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Liver Transplantation
HIV
Hepacivirus
Highly Active Antiretroviral Therapy
CD4 Lymphocyte Count
Recurrence
RNA
T-Lymphocytes
Ribavirin
Opportunistic Infections
Immunosuppressive Agents
Hepatitis C
Hepatitis B virus
Interferons
Italy
HIV-1
Liver Diseases
Survival Rate
Transplantation
Quality of Life

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

Vennarecci, G., Ettorre, G. M., Antonini, M., Santoro, R., Perracchio, L., Visco, G., & Santoro, E. (2007). Liver Transplantation in HIV-Positive Patients. Transplantation Proceedings, 39(6), 1936-1938. https://doi.org/10.1016/j.transproceed.2007.05.076

Liver Transplantation in HIV-Positive Patients. / Vennarecci, G.; Ettorre, G. M.; Antonini, M.; Santoro, R.; Perracchio, L.; Visco, G.; Santoro, E.

In: Transplantation Proceedings, Vol. 39, No. 6, 07.2007, p. 1936-1938.

Research output: Contribution to journalArticle

Vennarecci, G, Ettorre, GM, Antonini, M, Santoro, R, Perracchio, L, Visco, G & Santoro, E 2007, 'Liver Transplantation in HIV-Positive Patients', Transplantation Proceedings, vol. 39, no. 6, pp. 1936-1938. https://doi.org/10.1016/j.transproceed.2007.05.076
Vennarecci G, Ettorre GM, Antonini M, Santoro R, Perracchio L, Visco G et al. Liver Transplantation in HIV-Positive Patients. Transplantation Proceedings. 2007 Jul;39(6):1936-1938. https://doi.org/10.1016/j.transproceed.2007.05.076
Vennarecci, G. ; Ettorre, G. M. ; Antonini, M. ; Santoro, R. ; Perracchio, L. ; Visco, G. ; Santoro, E. / Liver Transplantation in HIV-Positive Patients. In: Transplantation Proceedings. 2007 ; Vol. 39, No. 6. pp. 1936-1938.
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