Table of Contents
ISRN Transplantation
Volume 2013, Article ID 480582, 8 pages
http://dx.doi.org/10.5402/2013/480582
Clinical Study

Long-Term Outcome of Liver Transplantation in HIV-1-Positive Patients: 15-Year Follow-Up

1Division of Transplantation Surgery F82, Karolinska University Hospital, Huddinge, 14186 Stockholm, Sweden
2Division of Infectious Disease, Karolinska University Hospital, Huddinge, 14186 Stockholm, Sweden
3Department of Gastroenterology and Hepatology, Karolinska University Hospital, Huddinge, 14186 Stockholm, Sweden
4Department of Clinical Pathology/Cytology and CLINTEC, Karolinska University Hospital, Huddinge and Karolinska Institutet, 14186 Stockholm, Sweden

Received 27 October 2013; Accepted 3 December 2013

Academic Editors: D. Caselli, M. Del Gaudio, and T. Yandza

Copyright © 2013 Shinji Yamamoto et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Liver transplantation (LT) for patients with human immunodeficiency virus type-1 (HIV-1) infection has been associated with poor outcome. However, after the introduction of the highly active antiretroviral therapy, short-term patient survival after LT has improved significantly. We examined the long-term outcome of HIV-1-positive patients who underwent LT. Medical records were analysed in nine HIV-1-positive LT patients who underwent LT from August 1998 to May 2012. Eight were known to be HIV-1 positive at the time of listing for LT and had end-stage liver disease (ESLD) due to hepatitis C. One patient had primary biliary cirrhosis, and primary HIV-1 infection was found at the date of LT. Seven of the nine patients remain alive to date. So far, three have survived more than 12 years after LT. The overall patient survival rate for both five and 10 years is 77.8%. Four patients experienced acute rejection and six acquired biopsy-confirmed HCV recurrence. HIV-1 replication was effectively blocked during follow-up in all patients. We conclude that long-term survival of HIV-1-positive patients after LT can be achieved. Our study suggests that LT can offer an effective treatment option in selected HIV-1 infected patients with ESLD.