Liver Transplantation for HIV/HCV Coinfection

Where Is the Controversy?

Emily Dannhorn; James P O'Beirne

Disclosures

Future Virology. 2013;8(7):639-648. 

In This Article

Conclusion

With the advances made in cART for the management of HIV, increasing numbers of patients are presenting with end-stage liver disease, commonly due to coinfection with HCV. After transplantation, the outcomes for this cohort have consistently been worse when compared with those for HCV-monoinfected patients. Rather than abandon this indication for LT, the liver transplant community needs to respond to the challenge and use the currently available evidence to revise the selection criteria and allocation policies for this group of patients. It is already possible to define a group of patients who will do as well as other non-HIV-infected LT recipients, and simple changes to the selection of candidates for LT will improve outcomes further. Due to the use of antivirals, LT outcomes for patients transplanted for HBV/HIV coinfection are excellent and the advent of the DAAs to treat HCV offers the very real possibility that HIV/HCV will very quickly become an excellent indication for LT.

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