AIDSWEEKLY Plus; Monday, December 29, 2003
Staff Medical Writers

According to published research from the United States, "Human immunodeficiency virus (HIV) infection has been considered an absolute contraindication to solid-organ transplantation."

"With immune function restoration possible with highly active antiretroviral therapy (HAART)," M.V. Ragni and coauthors at the University of Pittsburgh "evaluated 24 HIV-positive subjects with end-stage liver disease who were undergoing orthotopic liver transplantation (OLTX) after the availability of HAART."

"The cumulative survival among HIV-positive recipients was similar to that among age- and race-comparable HIV-negative recipients (p=0.365, by log-rank test)," they wrote in the Journal of Infectious Diseases. "At 12, 24, and 36 months after OLTX, survival was, respectively, 87.1%, 72.8%, and 72.8% among HIV-positive patients, versus 86.6%, 81.6%, and 77.9% among HIV-negative patients."

"Survival was poorer among subjects with post-OLTX antiretroviral intolerance (p=0.044), a post-OLTX CD4+ cell count of <200 cells/microL (p=0.005), a post-OLTX HIV load of >400 copies/mL (p=0.016), and hepatitis C virus infection (p=0.023)," study data showed.

"These findings suggest that survival of HIV-positive liver transplant recipients does not differ from that of HIV-negative liver transplant recipients, and they suggest that HIV infection should no longer be a contraindication to OLTX," the investigators concluded. "Further prospective studies are warranted."

Ragni and colleagues published their study in the Journal of Infectious Diseases (Survival of human immunodeficiency virus-infected liver transplant recipients. J Infect Dis. 2003 Nov 15;188(10):1412-20.

Additional information can be obtained by contacting M.V. Ragni, University of Pittsburgh, School of Medicine, Department of Medicine, 3636 Blvd. Allies, Pittsburgh, PA 15213, USA.

The publisher of the Journal of Infectious Diseases can be contacted at: University of Chicago Press, 1427 E. 60th St., Chicago, IL 60637-2954, USA.

The information in this article comes under the major subject areas of AIDS & HIV, Gastroenterology, Hepatology, Liver Transplantation and Virology.

This article was prepared by AIDS Weekly editors from staff and other reports.

Reference

Ragni MV, Belle SH, Im K, et al., "Survival of human immunodeficiency virus-infected liver transplant recipients", J Infect Dis. 2003 Nov 15;188(10):1412-20

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