Epidemiology and outcome of infections in human immunodeficiency virus/hepatitis C virus-coinfected liver transplant recipients: a FIPSE/GESIDA prospective cohort study.

Information about infections unrelated to acquired immunodeficiency syndrome (AIDS) in human immunodeficiency virus (HIV)-infected liver recipients is scarce. The aims of this study were to describe the prevalence, clinical characteristics, time of onset, and outcomes of bacterial, viral, and fungal infections in HIV/hepatitis C virus (HCV)-coinfected orthotopic liver transplant recipients and to identify risk factors for developing severe infections. We studied 84 consecutive HIV/HCV-coinfected patients who underwent liver transplantation at 17 sites in Spain between 2002 and 2006 and were followed until December 2009.

The model for end-stage liver disease score is the best prognostic factor in human immunodeficiency virus 1-infected patients with end-stage liver disease: a prospective cohort study.

End-stage liver disease (ESLD) has become the main cause of mortality in patients coinfected by human immunodeficiency virus (HIV) and hepatitis B virus or hepatitis C virus in developed countries. The aim of this study was to describe the natural history of and prognostic factors for ESLD, with particular attention paid to features affecting liver transplantation. This was a prospective cohort study in 2 Spanish community-based hospitals performed between 1999 and 2004.

Management of end-stage liver disease in HIV-infected patients.

Purpose Of Review: This review provides information on the natural history of end-stage liver disease in HIV/hepatitis C virus-coinfected patients from diagnosis to liver transplantation or death and summarizes recent developments in the epidemiology, management, and prognosis of end-stage liver disease and orthotopic liver transplantation in this population compared with the HIV-negative population.

Recent Findings: Many studies have described epidemiological aspects, including the increasing incidence of end-stage liver disease, as a cause of non-AIDS-related death in the co-infected population in developed countries, whereas other reports have focused on the clinical presentation and prognosis of end-stage liver disease in this specific clinical setting. The medical management of end-stage liver disease should be the same as for the HIV-negative population, and orthotopic liver transplantation is the only therapeutic option for HIV-infected patients who are eligible for this procedure.

Liver transplantation in HIV/hepatitis co-infection.

The prognosis of HIV infection has dramatically improved in recent years with the introduction of combined antiretroviral therapy. Currently, liver disease is one of the most important causes of morbidity and mortality, even more so given the high rate of hepatitis C virus co-infection in countries where drug abuse has been an important HIV risk factor. Survival of HIV-co-infected patients with end-stage liver disease (ESLD) is poor and shorter than that of the non-HIV-infected population.

Management of end stage liver disease (ESLD): what is the current role of orthotopic liver transplantation (OLT)?

Liver disease due to chronic hepatitis B and C is now a leading cause of morbidity and mortality among HIV-infected patients in the developed world, where classical opportunistic complications of severe immunodeficiency have declined dramatically. Orthotopic liver transplantation (OLT) is the only therapeutic option for patients with end-stage liver disease (ESLD). Accumulated experience in North America and Europe in the last 5 years indicates that 3-year survival in selected HIV-infected recipients of liver transplants was similar to that of HIV-negative recipients.

[GESIDA/GESITRA-SEIMC, PNS and ONT consensus document on solid organ transplant (SOT) in HIV-infected patients in Spain (March, 2005)].

Solid organ transplant may be the only therapeutic alternative in some HIV-infected patients. Experience in North America and Europe during the last five years shows that survival at three years after an organ transplant is similar to that observed in HIV-negative patients. The criteria agreed upon to select HIV patients for transplant are: no opportunistic infections (except tuberculosis, oesophageal candidiasis or P.

[Liver transplantation in patients with HIV infection: a reality in 2004].

According to current estimates, there are 60,000 to 80,000 HIV and HCV coinfected individuals in Spain, and 5,000 to 10,000 HIV and HBV coinfected individuals. Among these patients, 10% to 15% have liver cirrhosis. Thus, end-stage liver disease is one of the major causes of death in our country.

Preconditioning protects liver and lung damage in rat liver transplantation: role of xanthine/xanthine oxidase.

This study was designed to evaluate whether ischemic preconditioning could confer protection against liver and lung damage associated with liver transplantation. The effect of preconditioning on the xanthine/xanthine oxidase (XOD) system in liver grafts subjected to 8 and 16 hours of cold ischemia was also evaluated. Increased xanthine levels and marked conversion of xanthine dehydrogenase (XDH) to XOD were observed after hepatic cold ischemia.