Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
Surg Today. 2011 Oct;41(10):1325-31. doi: 10.1007/s00595-010-4556-x. Epub 2011 Sep 16.
Liver transplantation for patients with hepatitis C virus (HCV) and human immunodeficiency virus (HIV) remains challenging. The advent of highly active antiretroviral therapy (HAART) for HIV has reduced mortality from opportunistic infection related to acquired immunodeficiency syndrome dramatically, while about 50% of patients die of end-stage liver cirrhosis resulting from HCV. In Japan, liver cirrhosis frequently develops after HCV-HIV coinfection resulting from previously transfused infected blood products for hemophilia. The problems of liver transplantation for those patients arise from the need to control calcineurin inhibitor with HAART drugs, the difficulty of using interferon after liver transplantation with HAART, and the need to control intraoperative coagulopathy associated with hemophilia. We review published reports of liver transplantation for these patients in the updated world literature.
肝移植治疗丙型肝炎病毒（HCV）和人类免疫缺陷病毒（HIV）合并感染的患者仍然具有挑战性。高效抗逆转录病毒疗法（HAART）的出现显著降低了与获得性免疫缺陷综合征相关的机会性感染导致的死亡率，而大约 50%的患者死于 HCV 导致的终末期肝硬化。在日本，由于先前输注受感染的血液制品治疗血友病，HCV-HIV 合并感染后常导致肝硬化。这些患者肝移植存在一些问题，包括需要用 HAART 药物来控制钙调神经磷酸酶抑制剂、HAART 后肝移植时使用干扰素较为困难，以及需要控制与血友病相关的术中凝血功能障碍。我们对最新世界文献中关于这些患者肝移植的报道进行了综述。
