HCV recurrence in HIV-infected patients after liver Transplant

Christopher B. Hughes, Rolland C. Dickson, Murli Krishna, Darrin L. Willingham, Raj Satyanarayana, Denise M. Harnois, Andrew P. Keaveny, Barry Rosser, Jaime Aranda-Michel, David J. Kramer, Walter Hellinger, Julio Mendez

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Patients coinfected with hepatitis C virus (HCV) and HIV undergoing liver transplantation (LT) are at risk of early, aggressive HCV recurrence. This study investigates the use of frequent protocol-driven biopsies to identify HCV recurrence post LT in coinfected patients. Five consecutive HIV/HCV-coinfected patients underwent LT. Liver biopsies were obtained post LT at 1 hour; days 7, 120, and 365; then annually; and as clinically indicated. Stage 2 (Ishak) or higher fibrosis occurred in 4 of the 5 patients by 60, 120, 270, and 365 days. Two patients died of HCV recurrence and liver failure at 6 and 35 months post LT. Three patients survived more than 4 years after LT, 2 having sustained virologic responses to anti-HCV treatment. Another has histologic recurrence not responding to treatment. Hepatitis C virus recurrence can be rapid and aggressive after LT in HIV-coinfected patients. Serial biopsies identify recurrence early, allowing for prompt initiation of treatment.

Original languageEnglish (US)
Pages (from-to)87-93
Number of pages7
JournalJournal of the International Association of Physicians in AIDS Care
Volume9
Issue number2
DOIs
StatePublished - Mar 2010

Keywords

  • HIV/AIDS
  • Hepatitis C virus
  • Ishak score
  • Liver transplantation
  • Pegylated interferon

ASJC Scopus subject areas

  • Immunology
  • Dermatology
  • Infectious Diseases

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