Editorial
Copyright ©2011 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastrointest Surg. Feb 27, 2011; 3(2): 21-28
Published online Feb 27, 2011. doi: 10.4240/wjgs.v3.i2.21
Liver transplantation in HCV/HIV positive patients
Yasuhiko Sugawara, Sumihito Tamura, Norihiro Kokudo
Yasuhiko Sugawara, Sumihito Tamura, Norihiro Kokudo, Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
Author contributions: Sugawara Y, Tamura S and Kokudo N wrote this editorial together.
Supported by a Grant-in-aid for Scientific Research from the Ministry of Education, Culture, Sports, Science and Technology of Japan
Correspondence to: Yasuhiko Sugawara, MD, Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. yasusuga-tky@umin.ac.jp
Telephone: +81-3-38155411 Fax: +81-3-56843989
Received: September 19, 2010
Revised: January 15, 2011
Accepted: January 21, 2011
Published online: February 27, 2011
Abstract

Since the introduction of highly active antiretroviral therapy (HAART) in 1996 for human immunodeficiency virus (HIV)-infected patients, the incidence of liver diseases secondary to co-infection with hepatitis C has increased. Although data on the outcome of liver transplantation in HIV-infected recipients is limited, the overall results to date seem to be comparable to that in non-HIV-infected recipients. Liver transplant centers are now accepting HIV-infected individuals as organ recipients. Post-transplantation HIV replication is controlled by HAART. Hepatitis C re-infection of the liver graft, however, remains an important problem because cirrhotic changes of the liver graft may be more rapid in HIV-infected recipients. Interactions between the HAART components and immunosuppressive drugs influence drug metabolism and therefore meticulous monitoring of drug blood level concentrations is required. The risk of opportunistic infection in HIV-positive transplant patients seems to be similar to that in HIV-negative transplant recipients.

Keywords: Hepatitis C virus; Human immunodeficiency virus; Living donor liver transplantation; Interferon; Rivabirin