title: Fibrosing cholestatic hepatitis in HIV/HCV co-infected transplant patients-usefulness of early markers after liver transplantation.
abstract: We characterized fibrosing cholestatic hepatitis (FCH) in a large cohort of HIV/HCV co-infected patients. Between 1999 and 2008, 59 HIV infected patients were transplanted for end-stage liver disease due to HCV. Eleven patients (19%) developed FCH within a mean period of 7 months [2-27] after liver transplantation (LT). At Week 1 post-LT, the mean HCV viral load was higher in the FCH group: 6.13 log(10) IU/mL ± 1.30 versus 4.9 log(10) IU/mL ± 1.78 in the non-FCH group, p = 0.05. At the onset of acute hepatitis after LT, activity was moderate to severe in 8/11 HIV+/HCV+ patients with FCH (73%) versus 13/28 (46%) HIV+/HCV+ non-FCH (p = 0.007) patients. A complete virological response to anti-HCV therapy was observed in 2/11 (18%) patients. Survival differed significantly between the two groups (at 3 years, 67% in non-FCH patients versus 15% in FCH patients, p = 0.004). An early diagnosis of FCH may be suggested by the presence of marked disease activity when acute hepatitis is diagnosed and when a high viral load is present. The initiation of anti-HCV therapy should be considered at this point.
authors.affiliation: AP-HP Hôpital Paul Brousse, Centre Hépato-Biliaire, Villejuif, France.
authors.forename: T M
authors.initials: TM
authors.lastname: Antonini
authors.forename: M
authors.initials: M
authors.lastname: Sebagh
authors.forename: A M
authors.initials: AM
authors.lastname: Roque-Afonso
authors.forename: E
authors.initials: E
authors.lastname: Teicher
authors.forename: B
authors.initials: B
authors.lastname: Roche
authors.forename: R
authors.initials: R
authors.lastname: Sobesky
authors.forename: A
authors.initials: A
authors.lastname: Coilly
authors.forename: P
authors.initials: P
authors.lastname: Vaghefi
authors.forename: R
authors.initials: R
authors.lastname: Adam
authors.forename: D
authors.initials: D
authors.lastname: Vittecoq
authors.forename: D
authors.initials: D
authors.lastname: Castaing
authors.forename: D
authors.initials: D
authors.lastname: Samuel
authors.forename: J-C
authors.initials: JC
authors.lastname: Duclos-Vallée
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood*; D002780:Cholestasis, Intrahepatic; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000097:blood* / Q000150:complications; D006526:Hepatitis C / Q000097:blood / Q000150:complications / Q000601:surgery*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D019562:Viral Load
chemical_list: D015415:Biomarkers; D007166:Immunosuppressive Agents