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Survival and recurrence of hepatitis C after liver transplantation in patients coinfected with human immunodeficiency virus and hepatitis C virus†
Article first published online: 20 DEC 2007
Copyright © 2007 American Association for the Study of Liver Diseases
Volume 47, Issue 2, pages 407–417, February 2008
How to Cite
Duclos-Vallée, J.-C., Féray, C., Sebagh, M., Teicher, E., Roque-Afonso, A.-M., Roche, B., Azoulay, D., Adam, R., Bismuth, H., Castaing, D., Vittecoq, D. and Samuel, D. (2008), Survival and recurrence of hepatitis C after liver transplantation in patients coinfected with human immunodeficiency virus and hepatitis C virus. Hepatology, 47: 407–417. doi: 10.1002/hep.21990
Potential conflict of interest: Dr. Didier is a consultant for Novartis and Astellas Pharma.
The members of the THEVIC study group are listed in the appendix.
- Issue published online: 26 JAN 2008
- Article first published online: 20 DEC 2007
- Manuscript Accepted: 16 AUG 2007
- Manuscript Received: 9 MAY 2007
- Agence Nationale de Recherches sur le Sida et les Hepatites Virales (ANRS-HC08 program)
Liver transplantation in patients coinfected with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) is a recent indication. In a single center, we have compared the survival and severity of recurrent HCV infection after liver transplantation in HIV-HCV–coinfected and HCV-monoinfected patients. Seventy-nine patients receiving a first liver graft for HCV-related liver disease between 1999 and 2005 were included. Among them, 35 had highly active antiretroviral therapy–controlled HIV infection. All patients were monitored for HCV viral load and liver histology during the posttransplantation course. Coinfected patients were younger (43 ± 6 versus 55 ± 8 years, P < 0.0001) and had a higher Model for End-Stage Liver Disease (MELD) score (18.8 ± 7.4 versus 14.8 ± 4.7; P = 0.008). The 2-year and 5-year survival rates were 73% and 51% and 91% and 81% in coinfected patients and monoinfected patients, respectively (log-rank P = 0.004). Under multivariate Cox analysis, survival was related only to the MELD score (P = 0.03; risk ratio, 1.08; 95% confidence interval, 1.01, 1.15). Using the Kaplan-Meier method, the progression to fibrosis ≥ F2 was significantly higher in the coinfected group (P < 0.0001). Conclusion: The results of liver transplantation in HIV-HCV–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 HCV, and an avoidance of drug toxicity are mandatory if we are to improve the results of this challenging indication for liver transplantation. (HEPATOLOGY 2007.)