PRESS-NEWS.org - Press Release Distribution
PRESS RELEASES DISTRIBUTION

Patients infected with HIV have higher drop-out rate for liver transplantation

Survival following transplant surgery for liver cancer not impacted by HIV-positive status

2011-01-26
(Press-News.org) French researchers determined that infection with human immunodeficiency virus (HIV) impaired results of transplant surgery for liver cancer, with more HIV infected patients dropping off the transplantation wait list. The team found that overall survival and recurrence-free survival was not impacted following liver transplantation in patients with controlled HIV disease. Details of this single center study—the largest to date—are published in the February issue of Hepatology, a peer-reviewed journal of the American Association for the Study of Liver Diseases (AASLD).

More than 40 million individuals are infected with HIV; of these roughly two to four million and four to five million are also carriers of chronic hepatitis B virus (HBV) and hepatitis C virus (HCV), respectively. With the introduction of highly active antiretroviral therapy (HAART) in 1996 the survival of patients with HIV infection has improved dramatically and now end-stage liver disease has become the principal cause of death among HIV- positive patients co-infected HBV or HCV. Prior studies have shown that 25% of liver-related mortality in HIV-positive patients is attributable to hepatocellular carcinoma (HCC), or liver cancer.

"Liver transplantation is the optimum treatment for HCC and can also be considered for controlled HIV-positive patients with liver cancer," said René Adam, MD, PhD, from Hospital Paul Brousse in France and lead author of the current study. "Our study showed that HIV infection impaired the results of liver transplantation on an intent-to-treat basis but exerted no significant impact on overall survival and recurrence-free survival following transplantation."

The research team analyzed data from 21 HIV-infected and 65 HIV-negative patients with HCC who were listed for liver transplantation between 2003 and 2008. All HIV-positive patients were treated with HAART and had not experience any AIDS event or opportunistic infections prior to being place on the wait list.

Researchers observed a trend towards a higher drop-out among HIV-positive wait listed patients (23%) compared to patients without HIV (10%). Patients with HIV who dropped out had significantly higher alpha-fetoprotein (AFP) levels at the time of listing than those who received a transplant—98 μg/L versus 12 μg/L, respectively. A similar difference in AFP levels was not found in HIV-negative patients—18 μg/L in those who dropped out versus 13 μg/L for those who underwent liver transplantation. Only one HIV-positive patient who did not have increased AFP levels while on the wait list dropped out due to progression from controlled HIV to AIDS.

Medical evidence indicates a major predictive factor for HCC recurrence post-transplantation is an increase in patient's AFP level of more than 15 μg/L per month while on the waiting list. "Our study confirmed the importance of this preoperative factor (AFP levels), as all HIV-positive patients who dropped out displayed a rise in AFP levels," Dr. Adam concluded. "There is clearly a critical need for more effective neoadjuvant therapy in HIV-positive patients with HCC, however there are no objective arguments to contraindicate liver transplantation in this group if strict criteria are used for selection and patients are closely monitored until surgery."

INFORMATION: Article: "Liver transplantation for Hepatocellular Carcinoma: The Impact of HIV Infection." Eric Vibert, Jean-Charles Duclos-Vallée, Maria-Rosa Guigna, Emir Hoti, Chady Salloum, Catherine Guettier, Denis Castaing, Didier Samuel, René Adam. Hepatology; Published Online: January 3, 2010 (DOI: 10.1002/hep.24062); Print Issue Date: February 2011. http://onlinelibrary.wiley.com/doi/10.1002/hep.24062/abstract.

These studies are published in Hepatology. Media wishing to receive a PDF of the articles may contact healthnews@wiley.com.

About the Journal

Hepatology is the premier publication in the field of liver disease, publishing original, peer-reviewed articles concerning all aspects of liver structure, function and disease. Each month, the distinguished Editorial Board monitors and selects only the best articles on subjects such as immunology, chronic hepatitis, viral hepatitis, cirrhosis, genetic and metabolic liver diseases and their complications, liver cancer, and drug metabolism. Hepatology is published on behalf of the American Association for the Study of Liver Diseases (AASLD). For more information, please visit http://onlinelibrary.wiley.com/journal/10.1002/(ISSN)1527-3350.

About Wiley-Blackwell

Wiley-Blackwell is the international scientific, technical, medical, and scholarly publishing business of John Wiley & Sons, with strengths in every major academic and professional field and partnerships with many of the world's leading societies. Wiley-Blackwell publishes nearly 1,500 peer-reviewed journals and 1,500+ new books annually in print and online, as well as databases, major reference works and laboratory protocols. For more information, please visit www.wileyblackwell.com or our new online platform, Wiley Online Library (wileyonlinelibrary.com), one of the world's most extensive multidisciplinary collections of online resources, covering life, health, social and physical sciences, and humanities.



ELSE PRESS RELEASES FROM THIS DATE:

Researchers identify gene variants linked to hepatitis C treatment-related anemia

2011-01-26
In two recent studies, researchers have identified two functional variants in the inosine triphosphatase (ITPA) gene that protect patients with hepatitis C virus (HCV) against anemia brought on by antiviral treatment. The ability to identify those patients protected against treatment-induced anemia will ensure completion of antiviral therapy and successful elimination of the virus. Full findings of these studies appear in the February issue of Hepatology, a journal published by Wiley-Blackwell on behalf of the American Association for the Study of Liver Diseases. Chronic ...

Climate tax on meat and milk results in less greenhouse gases

Climate tax on meat and milk results in less greenhouse gases
2011-01-26
A climate tax corresponding to €60/ton CO2eq on meat and milk could reduce greenhouse gas emissions from European agriculture by around seven per cent. If the land made available is used for bioenergy production, the decrease in emissions can be six times greater. This is shown by the researchers Kristina Mohlin, Stefan Wirsenius and Fredrik Hedenus, University of Gothenburg, Sweden, in an article published in the scientific journal Climatic Change. Kristina Mohlin is a PhD student at the Department of Economics at the University of Gothenburg. She wrote the article ...

The embryogenesis evidence of foregut duplication cyst

2011-01-26
Foregut duplication cyst of the stomach is rare. Foregut duplications may or may not communicate with the gastrointestinal tract, and are usually diagnosed at a young age. There have been relatively few case reports describing this entity. Adenocarcinoma has been reported in four cases of gastric duplication cyst, but not in cysts that have a ciliated epithelium. Controversy exists concerning the embryological origin of these anomalies. A research article to be published on January 7, 2011 in the World Journal of Gastroenterology addresses this question. The authors presented ...

Useful biomarkers for esophageal squamous cell carcinoma

2011-01-26
MicroRNAs (miRNAs) regulate gene expression by mainly binding to the 3′-UTR of target mRNAs, leading to mRNA degradation or translation inhibition. Esophageal squamous cell carcinoma (ESCC) is one of the most lethal malignancies in China. Many studies have reported the miRNA expression profiles in Barrett's esophagus and esophageal adenocarcinoma. However, the pathobiological significance of aberrant miRNA expression in human ESCC has not been well documented. A research article to be published on January 7, 2011 in the World Journal of Gastroenterology addresses ...

Seroprevalence of anti-HAV among patients with chronic viral liver disease

2011-01-26
Hepatitis A virus (HAV) is an epidemiologically important virus with a worldwide distribution and causes acute hepatitis in humans. Acute HAV superinfection causes severe liver disease, acute liver failure and even higher mortality rates in patients with underlying chronic liver disease (CLD). Numerous studies have identified CLD as a risk factor for fulminant hepatitis and death from acute HAV infection. A research article to be published on January 14, 2011 in the World Journal of Gastroenterology addresses this question. In this study, the authors investigated the ...

Is different approach needed for acute diverticulitis in younger patients?

2011-01-26
Acute diverticulitis is the most common complication of diverticular disease, and its clinical presentation varies from mild local inflammation to full-blown perforation. After resolution of an acute episode, the best management strategy is as yet undefined, due to the risk of further episodes and the risk associated with elective surgical resection. Historically, surgical resection has been advocated after one episode of complicated diverticulitis (diverticulitis with perforation of the bowel wall, which manifests as intra-abdominal abscesses or peritonitis) and after ...

Hemolysis and intestinal injury

2011-01-26
Hemolysis is not uncommon during cardiovascular surgery, resulting in elevated circulating levels of cell-free oxyhemoglobin (FHb). The effect of hemolysis on intestinal microcirculation and gut wall integrity is unclear. A research article to be published on January 14, 2011 in the World Journal of Gastroenterology addresses this question. An animal model was developed with FHb plasma levels similar to those found during cardiovascular surgery. The influence of circulating FHb on intestinal microcirculation was studied using fluorescent microspheres and intestinal injury ...

Small bowel blood flow in healthy subjects receiving low-dose aspirin

2011-01-26
Low-dose acetylsalicylic acid (ASA) has been widely used for prevention of cardiovascular and cerebrovascular events. Several studies have shown that mucosal breaks caused by taking low-dose ASA occurred not only in the upper gastrointestinal tract but also in the lower gastrointestinal tract. However the cause of small bowel injury is not clear. One of the mechanisms of drug-induced small bowel damage is decrease in blood flow. A research article to be published on January 14, 2011 in the World Journal of Gastroenterology addresses this question. The authors investigated ...

Dynamic systems in living cells break the rules

2011-01-26
There is considerable interest in understanding transport and information pathways in living cells. It is crucial for both the transport of, for example, medicine into cells, the regulation of cell life processes and their signalling with their environment. New research in biophysics at the Niels Bohr Institute shows surprisingly that the transport mechanisms do not follow the expected pattern. The results have been published in the scientific journal Physical Review Letters. The researchers studied fat molecules which are naturally occurring in cells. Using a special ...

Exercise improves symptoms in irritable bowel syndrome

2011-01-26
The study, which was conducted at Sahlgrenska University Hospital in Gothenburg and at Alingsås Hospital, included 102 IBS patients between the ages of 18 and 65. Half the group was randomly allocated to increase their physical activity and the other half to maintain their usual lifestyle. Both groups received supportive phone calls from a physiotherapist. The active group increased their physical activity on their own, but with the advice and support from the physiotherapist. "They were advised to perform moderate to vigorous physical activity for 20 to 30 minutes three ...

LAST 30 PRESS RELEASES:

Scientists unlock secrets behind flowering of the king of fruits

Texas A&M researchers illuminate the mysteries of icy ocean worlds

Prosthetic material could help reduce infections from intravenous catheters

Can the heart heal itself? New study says it can

Microscopic discovery in cancer cells could have a big impact

Rice researchers take ‘significant leap forward’ with quantum simulation of molecular electron transfer

Breakthrough new material brings affordable, sustainable future within grasp

How everyday activities inside your home can generate energy

Inequality weakens local governance and public satisfaction, study finds

Uncovering key molecular factors behind malaria’s deadliest strain

UC Davis researchers help decode the cause of aggressive breast cancer in women of color

Researchers discovered replication hubs for human norovirus

SNU researchers develop the world’s most sensitive flexible strain sensor

Tiny, wireless antennas use light to monitor cellular communication

Neutrality has played a pivotal, but under-examined, role in international relations, new research shows

Study reveals right whales live 130 years — or more

Researchers reveal how human eyelashes promote water drainage

Pollinators most vulnerable to rising global temperatures are flies, study shows

DFG to fund eight new research units

Modern AI systems have achieved Turing's vision, but not exactly how he hoped

Quantum walk computing unlocks new potential in quantum science and technology

Construction materials and household items are a part of a long-term carbon sink called the “technosphere”

First demonstration of quantum teleportation over busy Internet cables

Disparities and gaps in breast cancer screening for women ages 40 to 49

US tobacco 21 policies and potential mortality reductions by state

AI-driven approach reveals hidden hazards of chemical mixtures in rivers

Older age linked to increased complications after breast reconstruction

ESA and NASA satellites deliver first joint picture of Greenland Ice Sheet melting

Early detection model for pancreatic necrosis improves patient outcomes

Poor vascular health accelerates brain ageing

[Press-News.org] Patients infected with HIV have higher drop-out rate for liver transplantation
Survival following transplant surgery for liver cancer not impacted by HIV-positive status