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©The Author(s) 2015.
World J Gastroenterol. Nov 21, 2015; 21(43): 12311-12321
Published online Nov 21, 2015. doi: 10.3748/wjg.v21.i43.12311
Published online Nov 21, 2015. doi: 10.3748/wjg.v21.i43.12311
Table 1 Drug-drug interactions between directly acting anti-hepatitis C virus directly acting antiviral and combined anti-viral therapy
Anti-HCV DAA | cART not recommended | Dose changes |
Boceprevir | Atazanavir | |
Darunavir/ritonavir | ||
Efavirenz | ||
Ritonavir | ||
Telaprevir | Darunavir | Efavirenz - dose increased |
Lopinavir/ritonavir | to 1125 mg TDS | |
Simeprevir | Atazanavir | |
Efavirenz | ||
Darunavir/ritonavir | ||
Nevirapine | ||
Daclatasvir | - | Efavirenz - dose increased to 90 mg OD |
Atazanavir and protease inhibitors - dose reduced to 30 mg OD | ||
Sofosbuvir | Didanosine | |
Zidovudine |
Table 2 Criteria for liver transplantation in human immunodeficiency virus-positive individuals
The criteria for liver transplantation are met |
CD4+ cell count > 100 cells/μL (> 200 cells/μL with a previous history of opportunistic complications) |
HIV viral load < 50 copies/mL (using ultrasensitive Amplicor Monitor PCR assay) |
Absence of AIDS-defining illness1 |
Absence progressive multi-focal leukoencephalopathy, chronic intestinal cryptosporidiosis (> 1 mo) or primary CNS lymphoma |
Table 3 Prospective studies conducted in human immunodeficiency virus/hepatitis C virus co-infected patients undergoing liver transplantation
n | Patient survival | Incidence of ACR | Risk factors for death amongst HIV/HCV recipients1 | |
Miro et al[65], 2012 | HIV/HCV - 84 | 1, 3, 5 yr: 88%, 62%, 54% | 38% | HCV G1 |
HCV - 252 | 1, 3, 5 yr: 90%, 76%, 71%1 | 20%1 | Donor risk index | |
MELD score | ||||
Center < 1 transplant/yr2 | ||||
Terrault et al[66], 2012 | HIV/HCV - 89 | 1 and 3 yr: 92% and 79% | 39% | Combined liver-kidney transplant |
HCV - 235 | 1 and 3 yr: 76% and 60%1 | 24%1 | BMI < 21 | |
Anti-HCV positive donor | ||||
Older donor |
Table 4 Antiretroviral medications and their effect on calcineurin inhibitors
Drug | Effect on CNI level |
Protease inhibitor | |
Darunavir | ↑↑ |
Fosamprenavir | ↑↑ |
Lopinavir | ↑↑ |
Ritonavir | ↑↑↑ |
Saquinavir | ↑↑ |
Non nucleoside reverse transverse inhibitors | |
Efavirenz | ↓↓ |
Nevirapine | ↓↓ |
Integrase inhibitors | |
Raltegravir | No effect |
- Citation: Joshi D, Agarwal K. Role of liver transplantation in human immunodeficiency virus positive patients. World J Gastroenterol 2015; 21(43): 12311-12321
- URL: https://www.wjgnet.com/1007-9327/full/v21/i43/12311.htm
- DOI: https://dx.doi.org/10.3748/wjg.v21.i43.12311