Background/Aims: As life expectancy in HIV- HCV co- infected patients impro ves, end stage liver disease requiring liver transplantation (LT) may become an emerging problem. We report the Paul Brousse Hospital experie...Background/Aims: As life expectancy in HIV- HCV co- infected patients impro ves, end stage liver disease requiring liver transplantation (LT) may become an emerging problem. We report the Paul Brousse Hospital experience of transplantat ion for end stage cirrhosis in HIV- HCV co- infected patients. Methods: Seven consecutive HIV- HCV co- infected patients were transplanted between December 1999 and December 2002 for end stage liver disease due to HCV. All patients were treated by highly active antiretroviral therapy (HAART), HIV plasma viral load was < 400 copies/ml and median CD4 lymphocyte count was 306 cells/mm3 (range, 10 3- 510) before LT. At the time of evaluation (March 2003), the median follow- up was 21 months (range, 4- 40). Results: Two patients died, 4 and 22 months, r espectively after LT. At the last biopsy, METAVIR score was staged F4 in two pat ients, F3 in two, and F1 in one. Microvesicular steatosis was noted in nearly al l patients. The ratio of mitochondrial to nuclear DNA was low in three of four p atients examined as compared with the amount of liver mtDNA found in eight HIV- negative, HCV- infected controls (P=0.01). Conclusions: A significant defect i n the activity of the respiratory chain complex IV was noted in all five patient s studied. Mitochondrial hepatotoxicity and severe HCV recurrence occur in HIV- HCV co- infected patients after LT.展开更多
文摘Background/Aims: As life expectancy in HIV- HCV co- infected patients impro ves, end stage liver disease requiring liver transplantation (LT) may become an emerging problem. We report the Paul Brousse Hospital experience of transplantat ion for end stage cirrhosis in HIV- HCV co- infected patients. Methods: Seven consecutive HIV- HCV co- infected patients were transplanted between December 1999 and December 2002 for end stage liver disease due to HCV. All patients were treated by highly active antiretroviral therapy (HAART), HIV plasma viral load was < 400 copies/ml and median CD4 lymphocyte count was 306 cells/mm3 (range, 10 3- 510) before LT. At the time of evaluation (March 2003), the median follow- up was 21 months (range, 4- 40). Results: Two patients died, 4 and 22 months, r espectively after LT. At the last biopsy, METAVIR score was staged F4 in two pat ients, F3 in two, and F1 in one. Microvesicular steatosis was noted in nearly al l patients. The ratio of mitochondrial to nuclear DNA was low in three of four p atients examined as compared with the amount of liver mtDNA found in eight HIV- negative, HCV- infected controls (P=0.01). Conclusions: A significant defect i n the activity of the respiratory chain complex IV was noted in all five patient s studied. Mitochondrial hepatotoxicity and severe HCV recurrence occur in HIV- HCV co- infected patients after LT.
