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Research from Italy indicates that
HIV infection does not preclude liver transplant as treatment for
hepatocellular carcinoma (HCC) and is not a predictor of survival rates after
transplant. HCC is the most common type of liver cancer and can be caused by
infection with viral hepatitis. Alcoholism also is a risk factor.
The researchers, led by Dr. Fabrizio
Di Benedetto, associate professor of surgery at the University of Modena,
followed 155 patients who had received liver transplants for HCC at three
hospitals in Northern Italy, from 2004 to 2009. The patient group included 30
patients with HIV infection and 125 patients who did not have HIV. After
approximately 32 months, 6.7 percent of the HIV-infected patients had a
recurrence of HCC while 14.4 percent of the uninfected patients experienced
recurrence. One-year and three-year follow-ups after surgery showed no
difference in survival rates among patients.
The patients with HIV received
antiretroviral therapy (ART) until transplant surgery; then it was stopped
until liver function stabilized. None of them developed AIDS during the pause
in ART. The researchers concluded that new ART options for persons with HIV
might be responsible for improving control of the virus as well as the
post-transplant outcomes for HCC. The researchers believed that the high level
of coordination among liver surgeons, infectious disease physicians,
gastroenterologists, and oncologists made the results possible. They
recommended use of a multidisciplinary approach for HIV-infected patients with
HCC undergoing transplant surgery.
The full report, “Multicenter
Italian Experience in Liver Transplantation for Hepatocellular Carcinoma in
HIV-Infected Patients,” was published online in the journal The Oncologist
(2013; doi:10.1634/theoncologist.2012-0255).
The Friends of AIDS Foundation is
dedicated to enhancing the quality of life for HIV positive individuals and
empowering people to make healthy choices to prevent the spread of the HIV
virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.
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