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- Title
Infectious complications after liver transplantation in human immunodeficiency virus-infected recipients.
- Authors
Teicher, E.; Boufassa, F.; Vittecoq, D.; Antonini, T.M.; Tateo, M.‐G.; Coilly, A.; Roque‐Afonso, A.‐M.; Kassis‐Chikhani, N.; Lambotte, O.; Ichai, P.; Samuel, D.; Duclos‐Vallee, J.‐C.
- Abstract
Background Few studies have investigated infections in human immunodeficiency virus ( HIV)-infected liver transplant patients. The aim of this study was to describe the prevalence, time of onset, mortality of infectious complications, other than hepatitis C virus ( HCV), and to identify risk factors for their development in a large single-center cohort of HIV-infected liver transplant patients. Methods We studied 109 consecutive HIV-infected patients who underwent liver transplantation ( LT) between 1999 and 2010 and followed until December 2012. Results The median age was 44 years (interquartile range [ IQR] 41-49), 82.6% were male, and the median follow-up was 45.7 months ( IQR 14-65). The major indications for LT were HCV cirrhosis (61%) and hepatocellular carcinoma (19%). Forty patients (37%) developed at least 1 infection during the first year after LT. Twenty-eight (26%) patients had an episode of bacteremia. Five (4.6%) patients developed a cytomegalovirus infection. Fungal infections occurred in 5 (4.5%) patients. Four (3.6%) patients developed an HIV-related opportunistic infection. A total of 43 (39.4%) patients died during follow-up. Mortality related to infection occurred in 9 (7%) cases, and 20 (42.5%) patients died because of HCV recurrence. No patients died from opportunistic infections. Model for end-stage liver disease ( MELD) score >17 was associated with a 2-fold higher risk (hazard ratio 1.96; 95% confidence interval 1.01-3.80) of developing infectious complications. Conclusions Infections are not a major cause of mortality after LT in HIV patients and opportunistic infections of acquired immunodeficiency syndrome are infrequent. A MELD score >17 increased the risk of developing post- LT infectious complications. Recurrence of HCV infection remains a major cause of mortality.
- Subjects
LIVER transplantation; HIV infections; BACTERIAL diseases; MYCOSES; OPPORTUNISTIC infections
- Publication
Transplant Infectious Disease, 2015, Vol 17, Issue 5, p662
- ISSN
1398-2273
- Publication type
Article
- DOI
10.1111/tid.12422