Presented in part at the 16th Conference on Retroviruses and Opportunistic Infections, Montreal (Canada) in February 8–11, 2009. Abstract No. 833.
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Outcome of HCV/HIV-Coinfected Liver Transplant Recipients: A Prospective and Multicenter Cohort Study
Article first published online: 4 APR 2012
DOI: 10.1111/j.1600-6143.2012.04028.x
© Copyright 2012 The American Society of Transplantation and the American Society of Transplant Surgeons
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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
Publication History
- 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
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Keywords:
- HCV infection;
- HIV infection;
- Liver Transplantation;
- Spain;
- Survival
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.