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World J Gastroenterol. Jan 14, 2014; 20(2): 414-424
Published online Jan 14, 2014. doi: 10.3748/wjg.v20.i2.414
Outcomes and management of viral hepatitis and human immunodeficiency virus co-infection in liver transplantation
Stephen E Congly, Karen E Doucette, Carla S Coffin
Stephen E Congly, Carla S Coffin, Liver Unit, Division of Gastroenterology and Hepatology, University of Calgary, Calgary, AB T2N 4Z6, Canada
Karen E Doucette, Division of Infectious Diseases, University of Alberta, Edmonton, AB T6G 2R3, Canada
Author contributions: Congly SE, Doucette KE and Coffin CS contributed to this paper equally.
Correspondence to: Carla S Coffin, MD, MSc, FRCPC, Liver Unit, Division of Gastroenterology and Hepatology, University of Calgary, 6D21, Teaching, Research and Wellness Building 3280, Hospital Drive, Calgary, AB T2N 4Z6, Canada. cscoffin@ucalgary.ca
Telephone: +1-403-5925049 Fax: +1-403-5925090
Received: September 24, 2013
Revised: October 22, 2013
Accepted: November 3, 2013
Published online: January 14, 2014
Processing time: 117 Days and 2.4 Hours
Abstract

Liver transplantation for human immunodeficiency virus (HIV) positive patients with viral hepatitis co-infection is increasingly offered in many North American and European liver transplant centers. Prior studies have demonstrated acceptable post-transplant outcomes and no increased risk of HIV complications in patients co-infected with hepatitis B virus (HBV). However, liver transplantation in HIV positive patients with hepatitis C virus (HCV) has poorer outcomes overall, requiring careful selection of candidates. This review aims to summarize the published literature on outcomes after transplant in HIV patients with HBV or HCV related end-stage liver disease and recommendations for management. In particular the pre-transplant factors impacting outcomes in HCV/HIV co-infected candidates and importance of multidisciplinary management will be discussed.

Keywords: Hepatitis B virus; Human immunodeficiency virus co-infection; Hepatitis C virus; Co-infection; Liver transplantation

Core tip: Liver transplantation is not contraindicated in viral hepatitis patients co-infected with human immunodeficiency virus. Patients should meet standard listing criteria for liver transplantation. Management of these patients should be done through a multidisciplinary management approach including pharmacists and infectious diseases physicians.