[Liver transplantation in a HIV-positive patient receiving potent antiretroviral therapy; the first case in The Netherlands]

Ned Tijdschr Geneeskd. 2004 Dec 11;148(50):2500-4.
[Article in Dutch]

Abstract

In a 49-year-old woman infected with HIV who was receiving highly-active antiretroviral treatment (HAART), terminal liver failure developed. She also had an acute exacerbation of hepatitis B. She was treated by means of liver transplantation and was in good condition two years later. At that time she was treated with tacrolimus, lamivudine, tenofovir, nelfinavir and hepatitis-B immunoglobulin. HIV-RNA and the DNA of hepatitis-B virus could not be detected, her CD4-count was not abnormal and the liver transplant functioned well. No opportunistic infections had developed. HIV infection has long been considered an absolute contraindication to solid organ transplantation, due to the increased risk of infection and rapid progression to AIDS. With HAART, restoration of immune function is possible. Currently, international experience with liver transplantation for HIV-positive patients that are not infected with hepatitis C has shown promising results. Specifically, the risks of transplant rejection, opportunistic infections and progression to AIDS are not increased. Therefore, criteria have been defined for solid organ transplantation in HIV-positive recipients.

Publication types

  • Case Reports

MeSH terms

  • Antiretroviral Therapy, Highly Active*
  • Contraindications
  • Female
  • HIV Infections / complications*
  • HIV Infections / drug therapy*
  • HIV Infections / immunology
  • Hepatitis B / complications*
  • Humans
  • Liver Failure / etiology
  • Liver Failure / therapy*
  • Liver Transplantation*
  • Middle Aged
  • Treatment Outcome