Clinical outcomes of liver transplantation in human immunodeficiency virus/hepatitis B virus coinfected patients in China

• Published in: BMC infectious diseases 2024-04, Vol.24 (1), p.383-383, Article 383
• Main Authors: Tang, Jianxin, Weng, Ruihui, Fang, Taishi, Zhang, Kangjun, Yan, Xu, Jin, Xin, Xie, Linjie, Zhao, Dong
• Format: Article
• Language: English
• Subjects: Antigens; Antiretroviral agents; Antiviral agents; Bacteremia; Biopsy; Blood; Care and treatment; Caspofungin; CD4 antigen; China; Chronic illnesses; Coinfection; Comorbidity; Comparative analysis; Complications; Complications and side effects; Cytomegalovirus; Cytomegalovirus infections; Demographic aspects; Disease prevention; Disease susceptibility; Drug dosages; Drug therapy; End Stage Liver Disease - surgery; End-stage liver disease; Graft rejection; Hepatitis; Hepatitis B; Hepatitis B - epidemiology; Hepatitis B virus; Hepatitis B virus - genetics; Highly active antiretroviral therapy; HIV; HIV (Viruses); HIV infection; HIV Infections - drug therapy; HIV patients; Human immunodeficiency virus; Humans; Immune system; Immunity; Infections; Liver; Liver cirrhosis; Liver diseases; Liver transplantation; Liver Transplantation - adverse effects; Liver transplants; Load distribution; Lymphocytes T; Medical prognosis; Medical research; Medicine, Experimental; Mortality; Patient outcomes; Patients; Postoperative; Postoperative Complications - etiology; Rank tests; Rankings; Retrospective Studies; Risk factors; RNA; Sepsis; Survival; T cells; Transplantation; Viruses
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-024-09284-2

Highly active antiretroviral therapy (HAART) has been able to improve the immune system function and survival of human immunodeficiency virus (HIV) patients. However, Patients coinfected with HIV and hepatitis B virus (HBV) are more likely to develop end-stage liver disease (ESLD) than those infected with HBV alone. Consequently, liver transplantation is often required for these patients. This study evaluates the outcomes of orthotopic liver transplantation (OLT) of HIV-HBV coinfected patients in China. We conducted a retrospective analysis on all HIV-HBV coinfected patients that underwent OLT from April 1, 2019 to December 31, 2021 and their outcomes were compared to all HBV monoinfected patients undergoing OLT during the same period. Patient outcomes were determined, including cumulative survival, viral load, CD4 T-cell count and postoperative complications. The median follow-up of HIV recipients was 36 months after OLT (interquartile range 12-39 months). Almost all patients had stable CD4 T-cell count (> 200 copies/ul), undetectable HBV DNA levels, and undetectable HIV RNA load during follow-up. The 1-, 2-, and 3-year posttransplant survival rates were 85.7% for the HIV group (unchanged from 1 to 3 years) versus 82.2%, 81.2%, and 78.8% for the non-HIV group. Cumulative survival among HIV-HBV coinfected recipients was not significantly different from the HBV monoinfected recipients (log-rank test P = 0.692). The percentage of deaths attributed to infection was comparable between the HIV and non-HIV groups (14.3% vs. 9.32%, P = 0.665). Post OLT, there was no significant difference in acute rejection, cytomegalovirus infection, bacteremia, pulmonary infection, acute kidney injury, de novo tumor and vascular and biliary complications. Liver transplantation in patients with HIV-HBV coinfection yields excellent outcomes in terms of intermediate- or long-term survival rate and low incidence of postoperative complications in China. These findings suggest that OLT is safe and feasible for HIV-HBV coinfected patients with ESLD. Chinese Clinical Trial Registry (ChiCTR2300067631), registered 11 January 2023.