Outcome of HCV/HIV-coinfected liver transplant recipients: a prospective and multicenter cohort study
J M Miro, M Montejo, L Castells, A Rafecas, S Moreno, F Agüero, M Abradelo, P Miralles, J Torre-Cisneros, J D Pedreira, E Cordero, G de la Rosa, B Moyano, A Moreno, I Perez, A Rimola, Spanish OLT in HIV-Infected Patients Working Group investigators, J D Pedreira, M A Castro, S López, F Suárez, P Vázquez, J M Miro, F Agüero, J Blanch, M Brunet, C Cervera, E de Lazzari, C Fondevila, A Forner, J Fuster, N Freixa, J C García-Valdecasas A Gil, J M Gatell, M Laguno, M Larrousse, J Mallolas, C Manzardo, M Monrás, A Moreno, J Murillas, D Paredes, I Pérez, F Torres, C Tural, M Tuset, A Rimola, A Antela, E Losada, E Molina, E Otero, E Varo, R Lozano, J J Araiz, E Barrao, J Larraga, S Letona, P Luque, A Navarro, I Sanjoaquín, T Serrano, E Tejero, M Salcedo, R Bañares, J Berenguer, G Clemente, J Cosín, J P Ferreiroa, J L García-Sabrido, I Gutiérrez, J C López, P Miralles, M Ramírez, D Rincón, M Sánchez, M Jiménez, J de la Cruz, J L Fernández, J M Lozano, J Santoyo, J M Rodrigo, M A Suárez, M Rodríguez, M P Alonso, V Asensi, M L González-Diéguez, I González-Pinto, A Rafecas, C Baliellas, J Carratalá, J Fabregat, N Fernández, R Jorba, L Lladó, X Xiol, M Montejo, J Bustamante, J R Fernández, M Gastaca, J González, E Montejo, J Ortiz de Urbina, P Ruiz, M J Suárez M Testillano, A Valdivieso, A Ventoso, M Abradelo, J Calvo, J R Costa, A García-Sesma, C Jiménez, A Manrique, J C Meneu, E Moreno, V Moreno, S P Olivares, F Pulido, R Rubio, M Blanes, V Aguilera, M Berenguer, J López, R López, M Prieto, M C Fariñas, F Casafont, S Echevarria, E Fábrega, J D García-Palomo, M Gomez-Fleitas, M Gutiérrez-Cuadra, G Saravia, S Moreno, R Barcena, S del Campo, P Martin-Dávila, J Fortún, A M Moreno, J Torre-Cisneros, P Barrera, J Briceño, J J Caston, G Costan, M de la Mata, R Lara, P López-Cillero, J L Montero, A Rivero, S Rufian, L I Castells, I Bilbao, I Campos-Varela, R Charco, J I Esteban, J Gavaldá, O Len, A Pahissa, E Ribera, V Vargas, J A Pons, E Cordero, C Bernal, J M Cisneros, M A Gómez, J M Pascasio, M J Rodríguez, M Sayago, J M Sousa, G Suárez, J González-García, E Aznar, E Barquilla, H Esteban, B Moyano, J M Miro, L Castells, G de la Rosa, J Torre-Cisneros, J Fortún, J González-García, L Guerra, F Lozano, M Manzanera, P Miralles, A Moreno, A Rafecas, A Rimola, P Stock, A Valdivieso, M Roland, D Samuel, S del Campo, H Esteban, J González-García, C Manzardo, E Montejo, B Moyano, M Manzanera, E Aznar, E Barquilla, H Esteban, J González-García, B Moyano, J M Miro, I Perez, C Mazardo, A Moreno, A Rimola, J M Miro, M Montejo, L Castells, A Rafecas, S Moreno, F Agüero, M Abradelo, P Miralles, J Torre-Cisneros, J D Pedreira, E Cordero, G de la Rosa, B Moyano, A Moreno, I Perez, A Rimola, Spanish OLT in HIV-Infected Patients Working Group investigators, J D Pedreira, M A Castro, S López, F Suárez, P Vázquez, J M Miro, F Agüero, J Blanch, M Brunet, C Cervera, E de Lazzari, C Fondevila, A Forner, J Fuster, N Freixa, J C García-Valdecasas A Gil, J M Gatell, M Laguno, M Larrousse, J Mallolas, C Manzardo, M Monrás, A Moreno, J Murillas, D Paredes, I Pérez, F Torres, C Tural, M Tuset, A Rimola, A Antela, E Losada, E Molina, E Otero, E Varo, R Lozano, J J Araiz, E Barrao, J Larraga, S Letona, P Luque, A Navarro, I Sanjoaquín, T Serrano, E Tejero, M Salcedo, R Bañares, J Berenguer, G Clemente, J Cosín, J P Ferreiroa, J L García-Sabrido, I Gutiérrez, J C López, P Miralles, M Ramírez, D Rincón, M Sánchez, M Jiménez, J de la Cruz, J L Fernández, J M Lozano, J Santoyo, J M Rodrigo, M A Suárez, M Rodríguez, M P Alonso, V Asensi, M L González-Diéguez, I González-Pinto, A Rafecas, C Baliellas, J Carratalá, J Fabregat, N Fernández, R Jorba, L Lladó, X Xiol, M Montejo, J Bustamante, J R Fernández, M Gastaca, J González, E Montejo, J Ortiz de Urbina, P Ruiz, M J Suárez M Testillano, A Valdivieso, A Ventoso, M Abradelo, J Calvo, J R Costa, A García-Sesma, C Jiménez, A Manrique, J C Meneu, E Moreno, V Moreno, S P Olivares, F Pulido, R Rubio, M Blanes, V Aguilera, M Berenguer, J López, R López, M Prieto, M C Fariñas, F Casafont, S Echevarria, E Fábrega, J D García-Palomo, M Gomez-Fleitas, M Gutiérrez-Cuadra, G Saravia, S Moreno, R Barcena, S del Campo, P Martin-Dávila, J Fortún, A M Moreno, J Torre-Cisneros, P Barrera, J Briceño, J J Caston, G Costan, M de la Mata, R Lara, P López-Cillero, J L Montero, A Rivero, S Rufian, L I Castells, I Bilbao, I Campos-Varela, R Charco, J I Esteban, J Gavaldá, O Len, A Pahissa, E Ribera, V Vargas, J A Pons, E Cordero, C Bernal, J M Cisneros, M A Gómez, J M Pascasio, M J Rodríguez, M Sayago, J M Sousa, G Suárez, J González-García, E Aznar, E Barquilla, H Esteban, B Moyano, J M Miro, L Castells, G de la Rosa, J Torre-Cisneros, J Fortún, J González-García, L Guerra, F Lozano, M Manzanera, P Miralles, A Moreno, A Rafecas, A Rimola, P Stock, A Valdivieso, M Roland, D Samuel, S del Campo, H Esteban, J González-García, C Manzardo, E Montejo, B Moyano, M Manzanera, E Aznar, E Barquilla, H Esteban, J González-García, B Moyano, J M Miro, I Perez, C Mazardo, A Moreno, A Rimola
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.
© Copyright 2012 The American Society of Transplantation and the American Society of Transplant Surgeons.
Source: PubMed