Changing Landscape of Liver Transplantation in the Post-DAA and Contemporary ART Era

Combination anti-retroviral therapy has drastically improved solid organ transplantation outcomes in persons living with HIV. DAA therapy has led to the successful eradication of HCV. While recent data have suggested improvement in outcomes in HIV/HCV-coinfected liver transplant recipients, temporal trends in patient survival within pre- and post-DAA eras are yet to be elucidated. The UNOS database was utilized to identify deceased donor liver transplant recipients between 1 January 2000 and 30 September 2020 and stratify them by HIV and HCV infection status. A total of 85,730 patients met the inclusion criteria. One-year and five-year patient survival improved (93% and 80%, respectively) for all transplants performed post-2015. For HIV/HCV-coinfected recipients, survival improved significantly from 78% (pre-2015) to 92% (post-2015). Multivariate regression analyses identified advanced recipient age, Black race, diabetes mellitus and decompensated cirrhosis as risk factors associated with higher one-year mortality. Liver transplant outcomes in HIV/HCV-coinfected liver transplant recipients have significantly improved over the last quinquennium in the setting of the highly effective combination of ART and DAA therapy. The presence of HIV, HCV, HIV/HCV-coinfection and active HCV viremia at the time of transplant do not cause higher mortality risk in liver transplant recipients in the current era.

Medienart:

E-Artikel

Erscheinungsjahr:

2022

Erschienen:

2022

Enthalten in:

Zur Gesamtaufnahme - volume:12

Enthalten in:

Life (Basel, Switzerland) - 12(2022), 11 vom: 01. Nov.

Sprache:

Englisch

Beteiligte Personen:

Saeed, Huma [VerfasserIn]
Cano, Edison J [VerfasserIn]
Khan, Mohammad Qasim [VerfasserIn]
Yetmar, Zachary A [VerfasserIn]
Smith, Byron [VerfasserIn]
Rizza, Stacey A [VerfasserIn]
Badley, Andrew D [VerfasserIn]
Mahmood, Maryam [VerfasserIn]
Leise, Michael D [VerfasserIn]
Cummins, Nathan W [VerfasserIn]

Links:

Volltext

Themen:

Anti-retroviral therapy
Direct-acting antiviral therapy
HIV/AIDS
Hepatitis C virus
Journal Article
Liver transplantation

Anmerkungen:

Date Revised 28.11.2022

published: Electronic

Citation Status PubMed-not-MEDLINE

doi:

10.3390/life12111755

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM348764944