Presented in part at the 16th Conference on Retroviruses and Opportunistic Infections, Montreal (Canada) in February 8–11, 2009. Abstract No. 833.
Outcome of HCV/HIV-Coinfected Liver Transplant Recipients: A Prospective and Multicenter Cohort Study
Article first published online: 4 APR 2012
© Copyright 2012 The American Society of Transplantation and the American Society of Transplant Surgeons
American Journal of Transplantation
Volume 12, Issue 7, pages 1866–1876, July 2012
How to Cite
Miro, J. M., Montejo, M., Castells, L., Rafecas, A., Moreno, S., Agüero, F., Abradelo, M., Miralles, P., Torre-Cisneros, J., Pedreira, J. D., Cordero, E., de la Rosa, G., Moyano, B., Moreno, A., Perez, I., Rimola, A. and the Spanish OLT in HIV-Infected Patients Working Group investigators (2012), Outcome of HCV/HIV-Coinfected Liver Transplant Recipients: A Prospective and Multicenter Cohort Study. American Journal of Transplantation, 12: 1866–1876. doi: 10.1111/j.1600-6143.2012.04028.x
- Issue published online: 28 JUN 2012
- Article first published online: 4 APR 2012
- Received 3 August 2011, revised 31 January 2012 and accepted for publication 2 February 2012
- HCV infection;
- HIV infection;
- Liver Transplantation;
Eighty-four HCV/HIV-coinfected and 252-matched HCV-monoinfected liver transplant recipients were included in a prospective multicenter study. Thirty-six (43%) HCV/HIV-coinfected and 75 (30%) HCV-monoinfected patients died, with a survival rate at 5 years of 54% (95% CI, 42–64) and 71% (95% CI, 66 to 77; p = 0.008), respectively. When both groups were considered together, HIV infection was an independent predictor of mortality (HR, 2.202; 95% CI, 1.420–3.413 [p < 0.001]). Multivariate analysis of only the HCV/HIV-coinfected recipients, revealed HCV genotype 1 (HR, 2.98; 95% CI, 1.32–6.76), donor risk index (HR, 9.48; 95% CI, 2.75–32.73) and negative plasma HCV RNA (HR, 0.14; 95% CI, 0.03–0.62) to be associated with mortality. When this analysis was restricted to pretransplant variables, we identified three independent factors (HCV genotype 1, pretransplant MELD score and centers with <1 liver transplantation/year in HIV-infected patients) that allowed us to identify a subset of 60 (71%) patients with a similar 5-year prognosis (69%[95% CI, 54–80]) to that of HCV-monoinfected recipients. In conclusion, 5-year survival in HCV/HIV-coinfected liver recipients was lower than in HCV-monoinfected recipients, although an important subset with a favorable prognosis was identified in the former.