Clinical

HIV no bar to liver transplantation

Last Updated: 2003-12-15 15:30:12 -0400 (Reuters Health)

By David Douglas

NEW YORK (Reuters Health) - HIV infection should no longer be considered a contraindication to liver transplantation, researchers from the US and UK report in the November 15th issue of the Journal of Infectious Diseases.

As lead investigator Dr. Margaret V. Ragni told Reuters Health, "this multicenter collaborative study demonstrated that survival in HIV-positive transplant recipients is similar to that found in age- and race-matched HIV-negative recipients."

Dr. Ragni of the University of Pittsburgh and colleagues hypothesized that the immune function restoration and improved survival made possible by highly active antiretroviral therapy might lead to such an outcome.

To investigate, the researchers followed 24 HIV-positive subjects with end-stage liver disease who were undergoing orthotopic liver transplantation.

Post-transplant survival was not significantly different in this group than it was in a cohort of HIV-negative subjects.

At 12 months, in the HIV-positive group, survival was 87.1%, and at 24 and 36 months it was 72.8%. Corresponding proportions in HIV-negative patients were 86.6%, 81.6% and 77.9%.

Survival was poorer in HIV patients with post-transplant antiretroviral intolerance, a CD4+ cell count of less than 200 cells per microliter, an HIV load of more than 400 copies per mL and hepatitis C infection.

Overall, Dr. Ragni added, these findings should "provide new hope for many HIV-infected patients who might otherwise die of end stage liver disease."

J Infect Dis 2003;188:1412-1420.