Human immunodeficiency virus infection does not worsen prognosis of liver transplantation for hepatocellular carcinoma

Agüero, F. ; Forner, A. ; Manzardo, C. ; Valdivieso, A. ; Blanes, M. ; Barcena, R. ; Rafecas, A. ; Castells, L. ; Abradelo, M. ; Torre-Cisneros, J. ; Gonzalez-Dieguez, L. ; Salcedo, M. ; Serrano, T. (Universidad de Zaragoza) ; Jimenez-Perez, M. ; Herrero, J. I. ; Gastaca, M. ; Aguilera, V. ; Fabregat, J. ; del Campo, S. ; Bilbao, I. ; Romero, C. J. ; Moreno, A. ; Rimola, A. ; Miro, J. M. ; Miro, J. M. ; Aguero, F. ; Blanch, J. ; Brunet, M. ; Calatayud, D. ; Cervera, C. ; Crespo, G. ; de Lazzari, E. ; Fondevila, C. ; Forner, A. ; Fuster, J. ; Forns, X. ; García-Valdecasas, J. C. ; Gil, A. ; Gatell, J. M. ; Laguno, M. ; Lligoña, A. ; Londoño, M. C. ; Mallolas, J. ; Manzardo, C. ; Monrás, M. ; Moreno, A. ; Murillas, J. ; Navasa, M. ; Paredes, D. ; Pérez, I. ; Tural, C. ; Tuset, M. ; Rimola, A. ; Torre-Cisneros J. ; Barrera, P. ; Briceño, J. ; Caston, J. J. ; Costan, G. ; de, la Mata ; Lara, R. ; López- Cillero, P. ; Montero, J. L. ; Rivero, A. ; Rufian, S. ; Suárez, F. ; Castro, M. A. ; López, S. ; Pedreira, J. D. ; Vázquez, P. ; Antela, A. ; Losada, E. ; Molina, E. ; Otero, E. ; Varo, E. ; Serrano, T. ; Araiz, J. J. (Universidad de Zaragoza) ; Barrao, E. ; Larraga, J. ; Letona, S. (Universidad de Zaragoza) ; Lozano, R. ; Luque, P. ; Navarro, A. ; Sanjoaquín, I. ; Tejero, E. ; Salcedo, M. ; Bañares, R. ; Berenguer, J. ; Clemente, G. ; Cosín, J. ; Ferreiroa, J. P. ; García-Sabrido, J. L. ; Gutiérrez, I. ; López, J. C. ; Miralles, P. ; Ramírez, M. ; Rincón, D. ; Sánchez, M. ; Jiménez, M. ; de, la Cruz ; Fernández, J. L. ; Lozano, J. M. ; Santoyo, J. ; Rodrigo, J. M. ; Suárez, M. A. ; Rodríguez, M. ; Alonso, M. P. ; Asensi, V. ; González-Diéguez, M. L. ; González-Pinto, I. ; Rafecas, A. ; Baliellas, C. ; Carratalá, J. ; Fabregat, J. ; Fernández, N. ; Jorba, R. ; Lladó, L. ; Xiol, X. ; Montejo, M. ; Bustamante, J. ; Fernández, J. R. ; Gastaca, M. ; González, J. ; Montejo, E. ; Ortiz, de Urbina ; Ruiz, P. ; Suárez, M. J. ; Testillano, M. ; Valdivieso, A. ; Ventoso, A. ; Abradelo, M. ; Calvo, J. ; Costa, J. R. ; García-Sesma, A. ; Jiménez, C. ; Manrique, A. ; Meneu, J. C. ; Moreno, E. ; Moreno, V. ; Olivares, S. P. ; Pulido, F. ; Rubio, R. ; Blanes, M. ; Aguilera, V. ; Berenguer, M. ; López, J. ; López, R. ; Prieto, M. ; Fariñas, M. C. ; Casafont, F. ; Echevarria, S. ; Fábrega, E. ; Gomez-Fleitas, M. ; Gutiérrez-Cuadra, M. ; Herrera-Noreña, J. L. ; Moreno, S. ; Barcena, R. ; del Campo, S. ; Fortún, J. ; Moreno, A. M. ; Martín- Dávila, P. ; Castells, L. l. ; Bilbao, I. ; Campos-Varela, I. ; Charco, R. ; Esteban, J. I. ; Gavaldá, J. ; Len, O. ; Pahissa, A. ; Ribera, E. ; Vargas, V. ; Pons, J. A. ; Cordero, E. ; Bernal, C. ; Cisneros, J. M. ; Gómez, M. A. ; Pascasio, J. M. ; Rodríguez, M. J. ; Sayago, M. ; Sousa, J. M. ; Suárez, G. ; González-García, J. ; Muffak, K. ; Ferrón, A. ; Garrote, D. ; Espinosa, M. ; Sánchez- Antolín, G. ; Garcia, F. ; Barrera, A. ; Bachiller, P. ; Conde, R. ; Noblejas, A. ; Escamilla, N. ; Pérez, I. ; Hayek, M. ; Linares, M. ; Arencibia, A. ; Minguelez, M. ; Aznar, E. ; Esteban, H. ; Moyano, B. ; de, la Rosa ; Garrido, G. ; Mahillo, B. ; Matesanz, R.

Resumen: The impact of human immunodeficiency virus (HIV) infection on patients undergoing liver transplantation (LT) for hepatocellular carcinoma (HCC) is uncertain. This study aimed to assess the outcome of a prospective Spanish nationwide cohort of HIV-infected patients undergoing LT for HCC (2002-2014). These patients were matched (age, gender, year of LT, center, and hepatitis C virus (HCV) or hepatitis B virus infection) with non-HIV-infected controls (1:3 ratio). Patients with incidental HCC were excluded. Seventy-four HIV-infected patients and 222 non-HIV-infected patients were included. All patients had cirrhosis, mostly due to HCV infection (92%). HIV-infected patients were younger (47 versus 51 years) and had undetectable HCV RNA at LT (19% versus 9%) more frequently than non-HIV-infected patients. No significant differences were detected between HIV-infected and non-HIV-infected recipients in the radiological characteristics of HCC at enlisting or in the histopathological findings for HCC in the explanted liver. Survival at 1, 3, and 5 years for HIV-infected versus non-HIV-infected patients was 88% versus 90%, 78% versus 78%, and 67% versus 73% (P = 0.779), respectively. HCV infection (hazard ratio = 7.90, 95% confidence interval 1.07-56.82) and maximum nodule diameter >3 cm in the explanted liver (hazard ratio = 1.72, 95% confidence interval 1.02-2.89) were independently associated with mortality in the whole series. HCC recurred in 12 HIV-infected patients (16%) and 32 non-HIV-infected patients (14%), with a probability of 4% versus 5% at 1 year, 18% versus 12% at 3 years, and 20% versus 19% at 5 years (P = 0.904). Microscopic vascular invasion (hazard ratio = 3.40, 95% confidence interval 1.34-8.64) was the only factor independently associated with HCC recurrence. Conclusions: HIV infection had no impact on recurrence of HCC or survival after LT. Our results support the indication of LT in HIV-infected patients with HCC.

Idioma: Inglés

DOI: 10.1002/hep.28321

Año: 2016

Publicado en: HEPATOLOGY 63, 2 (2016), 488-498
ISSN: 0270-9139

Factor impacto JCR: 13.246 (2016)

Categ. JCR: GASTROENTEROLOGY & HEPATOLOGY rank: 4 / 79 = 0.051 (2016) - Q1 - T1

Factor impacto SCIMAGO: 5.229 - Medicine (miscellaneous) (Q1) - Hepatology (Q1)

Tipo y forma: Article (Published version)

Área (Departamento): Area Medicina (Dpto. Medicina, Psiqu. y Derm.)