title: Outcome of HCV/HIV-coinfected liver transplant recipients: a prospective and multicenter cohort study.
abstract: Eighty-four HCV/HIV-coinfected and 252-matched HCV-monoinfected liver transplant recipients were included in a prospective multicenter study. Thirty-six (43%) HCV/HIV-coinfected and 75 (30%) HCV-monoinfected patients died, with a survival rate at 5 years of 54% (95% CI, 42-64) and 71% (95% CI, 66 to 77; p = 0.008), respectively. When both groups were considered together, HIV infection was an independent predictor of mortality (HR, 2.202; 95% CI, 1.420-3.413 [p < 0.001]). Multivariate analysis of only the HCV/HIV-coinfected recipients, revealed HCV genotype 1 (HR, 2.98; 95% CI, 1.32-6.76), donor risk index (HR, 9.48; 95% CI, 2.75-32.73) and negative plasma HCV RNA (HR, 0.14; 95% CI, 0.03-0.62) to be associated with mortality. When this analysis was restricted to pretransplant variables, we identified three independent factors (HCV genotype 1, pretransplant MELD score and centers with <1 liver transplantation/year in HIV-infected patients) that allowed us to identify a subset of 60 (71%) patients with a similar 5-year prognosis (69%[95% CI, 54-80]) to that of HCV-monoinfected recipients. In conclusion, 5-year survival in HCV/HIV-coinfected liver recipients was lower than in HCV-monoinfected recipients, although an important subset with a favorable prognosis was identified in the former.
authors.affiliation: Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain. jmmiro@ub.edu
authors.forename: J M
authors.initials: JM
authors.lastname: Miro
authors.forename: M
authors.initials: M
authors.lastname: Montejo
authors.forename: L
authors.initials: L
authors.lastname: Castells
authors.forename: A
authors.initials: A
authors.lastname: Rafecas
authors.forename: S
authors.initials: S
authors.lastname: Moreno
authors.forename: F
authors.initials: F
authors.lastname: Agüero
authors.forename: M
authors.initials: M
authors.lastname: Abradelo
authors.forename: P
authors.initials: P
authors.lastname: Miralles
authors.forename: J
authors.initials: J
authors.lastname: Torre-Cisneros
authors.forename: J D
authors.initials: JD
authors.lastname: Pedreira
authors.forename: E
authors.initials: E
authors.lastname: Cordero
authors.forename: G
authors.initials: G
authors.lastname: de la Rosa
authors.forename: B
authors.initials: B
authors.lastname: Moyano
authors.forename: A
authors.initials: A
authors.lastname: Moreno
authors.forename: I
authors.initials: I
authors.lastname: Perez
authors.forename: A
authors.initials: A
authors.lastname: Rimola
mesh_terms: D000328:Adult; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000601:surgery*; D006526:Hepatitis C / Q000150:complications / Q000601:surgery*; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D019562:Viral Load