title: Liver transplantation in patients with HIV infection.
abstract: 1. Liver transplantation for human immunodeficiency virus (HIV)-positive patients with end-stage liver disease in the era of highly active retroviral therapy has proven to be an effective treatment. The concerns of HIV progression have not been borne out by the growing worldwide experience. 2. CD4 counts are stable and HIV viral load is controllable with medication following liver transplantation. 3. Hepatitis C virus (HCV) coinfection in HIV-positive recipients is universal, but the severity of recurrence does not appear to be different from that in HIV-negative patients with HCV liver disease. 4. Complex pharmacokinetic interactions between the calcineurin inhibitors used for immunosuppression along with protease inhibitors are present, but management directed at recognizing the need for monitoring levels does not appear to increase the risk of toxicity. 5. The degree of immunosuppression from iatrogenic drug therapy and HIV does not lead to increased risk of infectious complications.
authors.affiliation: Department of Surgery, Thomas E. Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, PA, USA. fungj@ccf.org
authors.forename: John
authors.initials: J
authors.lastname: Fung
authors.forename: Bijan
authors.initials: B
authors.lastname: Eghtesad
authors.forename: Kusum
authors.initials: K
authors.lastname: Patel-Tom
authors.forename: Michael
authors.initials: M
authors.lastname: DeVera
authors.forename: Holly
authors.initials: H
authors.lastname: Chapman
authors.forename: Margaret
authors.initials: M
authors.lastname: Ragni
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000517:prevention & control; D023241:Antiretroviral Therapy, Highly Active; D004347:Drug Interactions; D006084:Graft Rejection; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D017093:Liver Failure / Q000150:complications* / Q000601:surgery*; D016031:Liver Transplantation / Q000592:standards / Q000639:trends
chemical_list: D007166:Immunosuppressive Agents