Kumar Rebecca N, Stosor Valentina
Division of Infectious Diseases and Travel Medicine, Georgetown University Medical Center, Washington, DC USA.
Divisions of Infectious Diseases and Organ Transplantation and Comprehensive Transplant Center, Northwestern University Feinberg School of Medicine, 645 North Michigan Avenue, Suite 900, Chicago, IL 60611 USA.
Curr Infect Dis Rep. 2022;24(3):39-50. doi: 10.1007/s11908-022-00776-3. Epub 2022 Mar 15.
Advanced liver disease is a leading cause of non-AIDS-related morbidity and mortality in persons with HIV on antiretroviral therapy. As a result, persons with HIV are increasingly seeking liver transplantation.
With the availability of direct-acting antiviral hepatitis C therapies, there has been a shift in the indications for liver transplantation in persons with HIV, with non-alcoholic fatty liver disease now the leading indication over hepatitis C infection. Additionally, liver transplant outcomes have improved in persons with HIV-hepatitis C co-infection persons with HIV. Preliminary results of HIV-to-HIV liver transplantation show acceptable results although rates of post-transplant infections and malignancies are areas of concern.
Future studies of liver transplantation in persons with HIV should focus on long-term outcomes, especially in the context of steatohepatitis and co-existing morbidities like diabetes, hyperlipidemia, and cardiovascular disease and other prevalent diseases in an aging population.
在接受抗逆转录病毒治疗的艾滋病毒感染者中，晚期肝病是导致非艾滋病相关发病和死亡的主要原因。因此，艾滋病毒感染者越来越多地寻求肝移植。
随着直接作用抗病毒丙肝疗法的出现，艾滋病毒感染者肝移植的适应症发生了转变，非酒精性脂肪性肝病现已成为超过丙肝感染的主要适应症。此外，艾滋病毒与丙肝合并感染的患者肝移植结果有所改善。艾滋病毒感染者之间肝移植的初步结果显示结果尚可，尽管移植后感染和恶性肿瘤的发生率令人担忧。
未来对艾滋病毒感染者肝移植的研究应关注长期结果，尤其是在脂肪性肝炎以及糖尿病、高脂血症和心血管疾病等并存疾病以及老年人群中其他常见疾病的背景下。
