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 27 May 2018

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Hep C recurrence after liver transplants is higher with HIV co-infection

This month's Hepatology investigates survival and recurrence of Hep C after liver transplants in patients coinfected with HIV-Hep C.

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Dr Jean-Charles Duclos-Vallée and team from France found Liver transplantation in patients coinfected with human immunodeficiency virus and hepatitis C virus is a recent indication.

The team have compared the survival and severity of recurrent Hepatitis C virus infection after liver transplantation in human immunodeficiency virus-HCV-coinfected and hepatitis C virus-monoinfected patients.

The team evaluated 79 patients receiving a first liver graft for Hepatitis C virus-related liver disease between 1999 and 2005.

2-year survival rates were 73% in co-infected patients
Hepatology

The team found among them, 35 had highly active antiretroviral therapy-controlled human immunodeficiency virus infection.

All patients were monitored for Hepatitis C virus viral load and liver histology during the posttransplantation course.

The team found coinfected patients were younger, and had a higher Model for End-Stage Liver Disease score.

The researchers noted that the 2-year and 5-year survival rates were 73% and 51%, in coinfected patients, respectively.

The research team observed that the 2-year and 5-year survival rates were 91% and 81% in monoinfected patients, respectively.

Under multivariate Cox analysis, survival was related only to the Model for End-Stage Liver Disease score.

Using the Kaplan-Meier method, the progression to fibrosis F2 was significantly higher in the coinfected group.

Dr Duclos-Vallée's team concluded, "The results of liver transplantation in human immunodeficiency virus-Hepatitis C virus-coinfected patients were satisfactory in terms of survival benefit."

"Earlier referral of these patients to a liver transplant unit, the use of new drugs effective against Hepatitis C virus, and an avoidance of drug toxicity are mandatory if we are to improve the results of this challenging indication for liver transplantation."

Hepatology 2008: 47(2): 407-17
04 February 2008

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