Citations 1
HCV Recurrence in HIV-Infected Patients After Liver Transplant
Hughes, Christopher B., Dickson, Rolland C. , Krishna, Murli , Willingham, Darrin L., Satyanarayana, Raj, Harnois, Denise M. , Rosser, Barry, Aranda‐Michel, Jaime, Kramer, David J., Hellinger, Walter C. , Mendez, Julio, Keaveny, Andrew P. , Rosser, Barry G.
Journal of the International Association of Physicians in AIDS Care | March 31, 2010 | Volume: 9 | Issue: 2 | Pages: 87-93
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.