Navigation Links
Patients infected with HIV have higher drop-out rate for liver transplantation
Date:1/25/2011

French researchers determined that infection with human immunodeficiency virus (HIV) impaired results of transplant surgery for liver cancer, with more HIV infected patients dropping off the transplantation wait list. The team found that overall survival and recurrence-free survival was not impacted following liver transplantation in patients with controlled HIV disease. Details of this single center studythe largest to dateare published in the February issue of Hepatology, a peer-reviewed journal of the American Association for the Study of Liver Diseases (AASLD).

More than 40 million individuals are infected with HIV; of these roughly two to four million and four to five million are also carriers of chronic hepatitis B virus (HBV) and hepatitis C virus (HCV), respectively. With the introduction of highly active antiretroviral therapy (HAART) in 1996 the survival of patients with HIV infection has improved dramatically and now end-stage liver disease has become the principal cause of death among HIV- positive patients co-infected HBV or HCV. Prior studies have shown that 25% of liver-related mortality in HIV-positive patients is attributable to hepatocellular carcinoma (HCC), or liver cancer.

"Liver transplantation is the optimum treatment for HCC and can also be considered for controlled HIV-positive patients with liver cancer," said Ren Adam, MD, PhD, from Hospital Paul Brousse in France and lead author of the current study. "Our study showed that HIV infection impaired the results of liver transplantation on an intent-to-treat basis but exerted no significant impact on overall survival and recurrence-free survival following transplantation."

The research team analyzed data from 21 HIV-infected and 65 HIV-negative patients with HCC who were listed for liver transplantation between 2003 and 2008. All HIV-positive patients were treated with HAART and had not experience any AIDS event or opportunistic infections prior to being place on the wait list.

Researchers observed a trend towards a higher drop-out among HIV-positive wait listed patients (23%) compared to patients without HIV (10%). Patients with HIV who dropped out had significantly higher alpha-fetoprotein (AFP) levels at the time of listing than those who received a transplant98 μg/L versus 12 μg/L, respectively. A similar difference in AFP levels was not found in HIV-negative patients18 μg/L in those who dropped out versus 13 μg/L for those who underwent liver transplantation. Only one HIV-positive patient who did not have increased AFP levels while on the wait list dropped out due to progression from controlled HIV to AIDS.

Medical evidence indicates a major predictive factor for HCC recurrence post-transplantation is an increase in patient's AFP level of more than 15 μg/L per month while on the waiting list. "Our study confirmed the importance of this preoperative factor (AFP levels), as all HIV-positive patients who dropped out displayed a rise in AFP levels," Dr. Adam concluded. "There is clearly a critical need for more effective neoadjuvant therapy in HIV-positive patients with HCC, however there are no objective arguments to contraindicate liver transplantation in this group if strict criteria are used for selection and patients are closely monitored until surgery."


'/>"/>

Contact: Dawn Peters
healthnews@wiley.com
781-388-8408
Wiley-Blackwell
Source:Eurekalert

Related medicine news :

1. Stress-Reduction Therapy May Help Heart Disease Patients
2. Breast Cancer Drug May Also Help Lung Cancer Patients
3. Study examines earlier use of heart pumps in growing group of heart failure patients
4. Breast Cancer Patients With Diabetes May Fare Worse
5. Strong social ties benefit breast cancer patients
6. Controlling symptoms can lead to improved quality of life for end-of-life patients
7. Gene test shows which bladder cancer patients may have cancer spread
8. Causes of death shifting in patients diagnosed with COPD
9. Fewer Cancer Patients May Be Depressed Than Thought
10. Stroke Risk May Be Higher in HIV Patients
11. Nurses Long Shifts May Put Hospital Patients at Risk: Study
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:2/6/2016)... CA (PRWEB) , ... February 06, 2016 , ... With ... and easily add warm color grades to their footage. A LUT is a Lookup ... pixel's color to the corresponding color indicated by the table. By manipulating each pixel, ...
(Date:2/5/2016)... ... February 05, 2016 , ... VeloReality President and ... generation LYNX VR Indoor Trainer with multi-rider capability to an enthusiastic audience at ... only reduce the weight of the unit, they also enhance the rider's experience ...
(Date:2/5/2016)... CA (PRWEB) , ... February 05, 2016 , ... ... to announce the addition of micro-needling services in their Napa Valley office. The ... founders of Plastic Surgery Associates, Dr. Canales and Dr. Furnas, are part of ...
(Date:2/5/2016)... San Rafael, CA (PRWEB) , ... February 05, 2016 , ... ... partnership with ChildLight Yoga Studio in Dover, NH to direct high-performance kids yoga training. ... on New Hampshire’s seacoast, just one hour from Boston. , ChildLight Yoga Studio founder ...
(Date:2/5/2016)... ... February 05, 2016 , ... Boar’s Head Brand®, one of the nation’s ... weekend’s Big Game. Take the stress out of your party preparation – follow these ... at every stage of the game. , “The key to hosting a successful game-day ...
Breaking Medicine News(10 mins):
(Date:2/5/2016)... 2016 France , Germany ... UK, and Israel ). It includes a 10-year epidemiology ... GD, segmented by age and sex in these markets. GD epidemiology report ... is in-depth, high quality, transparent and market-driven, providing expert analysis of disease ... Germany , Italy , Spain ...
(Date:2/4/2016)... IRVINE, Calif. , Feb. 4, 2016  Edwards ... in patient-focused innovations for structural heart disease and critical ... an accelerated share repurchase (ASR) agreement with Morgan Stanley ... common stock.  This repurchase is part of the Company,s ... of the Company,s common stock.  ...
(Date:2/4/2016)... YORK , Feb. 4, 2016   Bernstein Liebhard ... been filed in the United States District Court for the ... a class (the "Class") consisting of all persons or entities ... the "Company") (NASDAQ: INSY ) from March 3, 2015 ... Insys and certain of its officers with violations of the ...
Breaking Medicine Technology: