TY - JOUR
T1 - HCV recurrence in HIV-infected patients after liver Transplant
AU - Hughes, Christopher B.
AU - Dickson, Rolland C.
AU - Krishna, Murli
AU - Willingham, Darrin L.
AU - Satyanarayana, Raj
AU - Harnois, Denise M.
AU - Keaveny, Andrew P.
AU - Rosser, Barry
AU - Aranda-Michel, Jaime
AU - Kramer, David J.
AU - Hellinger, Walter
AU - Mendez, Julio
PY - 2010/3
Y1 - 2010/3
N2 - 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.
AB - 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.
KW - HIV/AIDS
KW - Hepatitis C virus
KW - Ishak score
KW - Liver transplantation
KW - Pegylated interferon
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UR - http://www.scopus.com/inward/citedby.url?scp=77953666906&partnerID=8YFLogxK
U2 - 10.1177/1545109710362592
DO - 10.1177/1545109710362592
M3 - Article
C2 - 20357036
AN - SCOPUS:77953666906
SN - 1545-1097
VL - 9
SP - 87
EP - 93
JO - Journal of the International Association of Physicians in AIDS Care
JF - Journal of the International Association of Physicians in AIDS Care
IS - 2
ER -