Tang JX, Zhao D. Current status of liver transplantation for human immunodeficiency virus-infected patients in mainland China. World J Gastroenterol 2024; 30(14): 1958-1962 [PMID: 38681123 DOI: 10.3748/wjg.v30.i14.1958]
Corresponding Author of This Article
Dong Zhao, MD, Chief Doctor, Department of Liver Surgery and Organ Transplantation Center, Shenzhen Third People’s Hospital, The Second Affiliated Hospital of Southern University of Science and Technology, National Clinical Research Center for Infectious Disease, No. 29 Bulan Road, Longgang District, Shenzhen 518000, Guangdong Province, China. zdong1233@126.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Apr 14, 2024; 30(14): 1958-1962 Published online Apr 14, 2024. doi: 10.3748/wjg.v30.i14.1958
Current status of liver transplantation for human immunodeficiency virus-infected patients in mainland China
Jian-Xin Tang, Dong Zhao
Jian-Xin Tang, Dong Zhao, Department of Liver Surgery and Organ Transplantation Center, Shenzhen Third People’s Hospital, The Second Affiliated Hospital of Southern University of Science and Technology, National Clinical Research Center for Infectious Disease, Shenzhen 518000, Guangdong Province, China
Author contributions: Zhao D contributed to study conception and design, and administrative support; Zhao D and Tang JX contributed to provision of the study materials, and collection and assembly of the data; and all authors contributed to the writing and final approval of the manuscript.
Supported bythe Shenzhen Science and Technology R&D Fund, No. JCYJ20220530163011026; and Shenzhen Third People’s Hospital, No. G2022008 and No. G2021008.
Conflict-of-interest statement: No conflict-of-interest to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dong Zhao, MD, Chief Doctor, Department of Liver Surgery and Organ Transplantation Center, Shenzhen Third People’s Hospital, The Second Affiliated Hospital of Southern University of Science and Technology, National Clinical Research Center for Infectious Disease, No. 29 Bulan Road, Longgang District, Shenzhen 518000, Guangdong Province, China. zdong1233@126.com
Received: December 28, 2023 Peer-review started: December 28, 2023 First decision: February 9, 2024 Revised: February 18, 2024 Accepted: March 21, 2024 Article in press: March 21, 2024 Published online: April 14, 2024
Abstract
According to the report from the Chinese Center for Disease Control and Prevention, the prevalence of human immunodeficiency virus (HIV) infection exceeded 1.2 million individuals by the year 2022, with an annual increase of about 80000 cases. The overall prevalence of hepatitis B surface antigen among individuals co-infected with HIV reached 13.7%, almost twice the rate of the general population in China. In addition to the well-documented susceptibility to opportunistic infections and new malignancies, HIV infected patients frequently experience liver-related organ damage, with the liver and kidneys being the most commonly affected. This often leads to the development of end-stage liver and kidney diseases. Therefore, organ transplantation has emerged as an important part of active treatment for HIV infected patients. However, the curative effect is not satisfactory. HIV infection has been considered a contraindication for organ transplantation. Until the emergence of highly active anti-retroviral therapy in 1996, the once intractable replication of retrovirus was effectively inhibited. With prolonged survival, the failure of important organs has become the main cause of death among HIV patients. Therefore, transplant centers worldwide have resumed exploration of organ transplantation for HIV-infected individuals and reached a positive conclusion. This study provides an overview of the current landscape of HIV-positive patients receiving liver transplantation (LT) in mainland China. To date, our transplant center has conducted LT for eight end-stage liver disease patients co-infected with HIV, and all but one, who died two months postoperatively due to sepsis and progressive multi-organ failure, have survived. Comparative analysis with hepatitis B virus-infected patients during the same period revealed no statistically significant differences in acute rejection reactions, cytomegalovirus infection, bacteremia, pulmonary infections, acute kidney injury, new-onset cancers, or vascular and biliary complications.
Core Tip: In mainland China, human immunodeficiency virus (HIV) infection has long been considered an absolute contraindication for liver transplantation (LT). Until June 2004, Chinese scholars performed LT on two HIV patients, but these cases were only followed up for 24 and 22 months, respectively. Subsequently, there were no reported cases of LT in mainland China for patients with HIV infection until April 2019, when our transplant center performed ABO-incompatible LT for a patient with liver failure co-infected with HIV and hepatitis B virus. This study provides an overview of the current landscape of HIV-positive patients receiving liver transplantation in mainland China.
