title: Resection and transplantation: evaluation of surgical perspectives in HIV positive patients affected by end-stage liver disease.
abstract: OBJECTIVE
  The aim of this study was to evaluate the opportunity of surgical treatment in terms of liver resection or liver transplantation in HIV positive patients affected by an end stage liver disease that referred to our liver unit.
  
  
  METHODS
  Among 1350 outpatients who referred to our liver unit from January 2002 to September 2003, thirty-two (2,4%) were HIV positive. The routes of transmission of the viral infection, the related co-infections and the underlying liver disease were recorded. The therapeutic pathway was analysed. The kind and the duration of the surgical procedures were assessed.
  
  
  RESULTS
  Fourteen (44%) of these thirty-two patients were not suitable for surgical treatment. Surgery was planned in 9 of 32 HIV positive patients (28%). Four patients (12%) were submitted to liver resection and OLT was performed in five patients (15%). Hepatocellular Carcinoma was present in 4 (44%) of the HIV positive patients considered for surgery.
  
  
  CONCLUSIONS
  In conclusion in our centre the 28% of HIV positive out patients had the opportunity to receive a surgical treatment. The candidate to this surgery is mostly young, HCV and/or HBV coinfected and affected by HCC in 44% of cases.
authors.affiliation: Department of Digestive Surgery and Liver Transplantation, IRCCS Regina Elena Cancer Institute, Rome, Italy.
authors.forename: G M
authors.initials: GM
authors.lastname: Ettorre
authors.forename: G
authors.initials: G
authors.lastname: Vennarecci
authors.forename: A
authors.initials: A
authors.lastname: Boschetto
authors.forename: L
authors.initials: L
authors.lastname: Giovannelli
authors.forename: M
authors.initials: M
authors.lastname: Antonini
authors.forename: F
authors.initials: F
authors.lastname: Carboni
authors.forename: R
authors.initials: R
authors.lastname: Santoro
authors.forename: P
authors.initials: P
authors.lastname: Lepiane
authors.forename: M
authors.initials: M
authors.lastname: Cosimelli
authors.forename: M T
authors.initials: MT
authors.lastname: Lonardo
authors.forename: F
authors.initials: F
authors.lastname: Del Nonno
authors.forename: L
authors.initials: L
authors.lastname: Perracchio
authors.forename: M
authors.initials: M
authors.lastname: Maritti
authors.forename: P
authors.initials: P
authors.lastname: Moricca
authors.forename: G
authors.initials: G
authors.lastname: D'Offizi
authors.forename: P
authors.initials: P
authors.lastname: Narciso
authors.forename: P
authors.initials: P
authors.lastname: Noto
authors.forename: E
authors.initials: E
authors.lastname: Boumis
authors.forename: N
authors.initials: N
authors.lastname: Petrosillo
authors.forename: G
authors.initials: G
authors.lastname: Visco
authors.forename: E
authors.initials: E
authors.lastname: Santoro
mesh_terms: D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000453:epidemiology; D015658:HIV Infections / Q000150:complications* / Q000635:transmission; D006509:Hepatitis B / Q000150:complications / Q000453:epidemiology / Q000635:transmission; D006526:Hepatitis C / Q000150:complications / Q000453:epidemiology / Q000635:transmission; D006801:Humans; D008107:Liver Diseases / Q000150:complications* / Q000601:surgery* / Q000821:virology*; D008113:Liver Neoplasms / Q000150:complications / Q000453:epidemiology; D016031:Liver Transplantation