Virologic and clinical outcomes of hepatitis B virus infection in HIV-HBV coinfected transplant recipients.

Journal Article (Journal Article)

Liver transplantation (LT) is the treatment of choice for end-stage liver disease, but is controversial in patients with human immunodeficiency virus (HIV) infection. Using a prospective cohort of HIV-hepatitis B virus (HBV) coinfected patients transplanted between 2001-2007; outcomes including survival and HBV clinical recurrence were determined. Twenty-two coinfected patients underwent LT; 45% had detectable HBV DNA pre-LT and 72% were receiving anti-HBV drugs with efficacy against lamivudine-resistant HBV. Post-LT, all patients received hepatitis B immune globulin (HBIG) plus nucleos(t)ide analogues and remained HBsAg negative without clinical evidence of HBV recurrence, with a median follow-up 3.5 years. Low-level HBV viremia (median 108 IU/mL, range 9-789) was intermittently detected in 7/13 but not associated with HBsAg detection or ALT elevation. Compared with 20 HBV monoinfected patients on similar HBV prophylaxis and median follow-up of 4.0 years, patient and graft survival were similar: 100% versus 85% in HBV mono- versus coinfected patients (p = 0.08, log rank test). LT is effective for HIV-HBV coinfected patients with complications of cirrhosis, including those who are HBV DNA positive at the time of LT. Combination HBIG and antivirals is effective as prophylaxis with no clinical evidence of HBV recurrence but low-level HBV DNA is detectable in approximately 50% of recipients.

Full Text

Duke Authors

Cited Authors

  • Coffin, CS; Stock, PG; Dove, LM; Berg, CL; Nissen, NN; Curry, MP; Ragni, M; Regenstein, FG; Sherman, KE; Roland, ME; Terrault, NA

Published Date

  • May 2010

Published In

Volume / Issue

  • 10 / 5

Start / End Page

  • 1268 - 1275

PubMed ID

  • 20346065

Pubmed Central ID

  • PMC3155863

Electronic International Standard Serial Number (EISSN)

  • 1600-6143

Digital Object Identifier (DOI)

  • 10.1111/j.1600-6143.2010.03070.x


  • eng

Conference Location

  • United States