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).
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