003). All six HBV isolates that could be sequenced were of genotype
A/subgenotype A1. Four of these six HBV isolates contained mutations associated with lamivudine resistance in the DNA polymerase (two with L180M/M204V and two with rt173V/180M/204V) and a specific substitution (Y100C) in the HBV small surface protein. Conclusions: HBV isolates with the identified substitutions have the potential to spread silently by nosocomial transmission within the hemodialysis unit. These results have potential implications for the management of patients with occult HBV infection undergoing hemodialysis. “
“Since the introduction of antiretroviral therapy (ART) in the mid-1990s, AIDS-related death has been dramatically reduced, and hepatitis-C-virus (HCV)-related liver failure or hepatocellular carcinoma has currently become the leading cause of death in HIV/HCV co-infected patients. Liver STA-9090 mouse transplantation may be one of the treatments of choices in such cases, but the indications for transplantation, perioperative management including both HIV and HCV treatments, immunosuppression and the prevention/treatment of infectious complications are all still topics of debate. With the improved understanding of the viral behaviors of both HIV and HCV and the development of novel strategies, especially to avoid drug
interactions between ART and immunosuppression, liver transplantation has become a realistic treatment for HIV/HCV co-infected patients. IN
JAPAN, IN the late 1980s, contaminated buy PLX3397 blood production of coagulation factor for hemophilia caused co-infection of HIV and hepatitis C virus (HCV). Actually, greater than 90% of HIV-infected patients have HCV as well. After antiretroviral therapy (ART) was introduced in the late 1990s, successful control of HIV was achieved in most cases and death due to AIDS was dramatically reduced, but HCV-related death due to liver failure or hepatocellular carcinoma became a serious problem, not only in Japan, but all over the world.[2-6] In such cases, triclocarban liver transplantation (LT) is the only treatment option to achieve long-term survival, but several modifications of perioperative management are required. In this review, the outcome and the points of management of LT for HIV/HCV co-infected patients were reviewed. THE REPORTED OUTCOMES of LT for HIV and HIV/HCV co-infected patients from Western countries after the introduction of ART are summarized in Table 1.[7-11] In general, most reports concluded that the results were worse than in the cases with HCV mono-infection, with a 3-year survival of approximately 60–70%. In Japan, the Tokyo group reported six cases of living donor liver transplantation (LDLT) between 2001 and 2004, of whom four died.