title: Role of liver transplantation in human immunodeficiency virus positive patients.
abstract: End-stage liver disease (ESLD) is a leading cause of morbidity and mortality amongst human immunodeficiency virus (HIV)-positive individuals. Chronic hepatitis B and hepatitis C virus (HCV) infection, drug-induced hepatotoxicity related to combined anti-retro-viral therapy, alcohol related liver disease and non-alcohol related fatty liver disease appear to be the leading causes. It is therefore, anticipated that more HIV-positive patients with ESLD will present as potential transplant candidates. HIV infection is no longer a contraindication to liver transplantation. Key transplantation outcomes such as rejection and infection rates as well as medium term graft and patient survival match those seen in the non-HIV infected patients in the absence of co-existing HCV infection. HIV disease does not seem to be negatively impacted by transplantation. However, HIV-HCV co-infection transplant outcomes remain suboptimal due to recurrence. In this article, we review the key challenges faced by this patient cohort in the pre- and post-transplant period.
authors.affiliation: Deepak Joshi, Kosh Agarwal, Institute of Liver Studies, King's College Hospital NHS Foundation Trust, Denmark Hill, SE5 9RS London, United Kingdom.
authors.forename: Deepak
authors.initials: D
authors.lastname: Joshi
authors.affiliation: Deepak Joshi, Kosh Agarwal, Institute of Liver Studies, King's College Hospital NHS Foundation Trust, Denmark Hill, SE5 9RS London, United Kingdom.
authors.forename: Kosh
authors.initials: K
authors.lastname: Agarwal
mesh_terms: D060085:Coinfection; D058625:End Stage Liver Disease / Q000175:diagnosis / Q000601:surgery* / Q000821:virology; D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control; D006085:Graft Survival; D015658:HIV Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D006526:Hepatitis C / Q000150:complications / Q000175:diagnosis; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects; D018579:Patient Selection; D012008:Recurrence; D018570:Risk Assessment; D012307:Risk Factors; D017741:Survivors; D013997:Time Factors; D016896:Treatment Outcome
keywords: Hepatitis B virus; Hepatitis C virus; Human immunodeficiency virus; Liver transplantation