This is in contrast with
HCV acquisition in non-haemophilic men, conservatively estimated to occur at age 15 years or later. As duration of HCV infection is a recognized risk factor for HCV progression , and, as at least one-fourth of co-infected haemophilic men have Metavir ≥ F3 fibrosis , we sought to determine whether transplant outcomes are poorer in co-infected haemophilic than non-haemophilic transplant candidates, within our larger study of OLTX in HIV-infected individuals. The HIV in Solid Organ Transplantation Multisite Study (HIV-TR) is a National Institute of Allergy and Infectious Diseases (NIAID)-funded prospective, observational trial that enrolled transplant candidates
with HIV infection and end-stage liver disease NVP-BGJ398 solubility dmso (ESLD) from 21 US university transplant centres between October 2003 and February 2010 (NCT00074386). This analysis includes transplant candidates from the eight centres that enrolled both haemophilic and non-haemophilic subjects. Inclusion criteria for the HIV-TR study, previously described , include CD4 + cells > 100/μL, or > 200/μL if there was a prior opportunistic infection; and undetectable HIV-1 RNA, or www.selleckchem.com/products/Imatinib-Mesylate.html predicted HIV suppression in those with hepatotoxicity or cART intolerance. Subjects with a history of progressive multifocal leukoencephalopathy, chronic intestinal cryptosporidiosis of >1 month duration, primary CNS lymphoma, multidrug resistant fungal infections, or significant wasting were excluded from the study. Patients with hepatocellular carcinoma were excluded from this analysis, as they are typically assigned to a higher priority for liver transplantation regardless of MELD score. Outcomes included transplant, rejection and mortality rates. As exact dates of HCV exposure remain unknown, we assumed HCV exposure occurred with initial clotting factor exposure during the first year of life among those with haemophilia
, and with sexual or intravenous Exoribonuclease drug use exposure at 15 years of age or later, conservatively, among non-haemophilic subjects. Clinical and laboratory data were collected on study subjects at screening, enrolment (time of placement on the transplant waiting list), and every 3 months until transplantation or death, and entered into an online data collection system at each of the participating sites. Clinical variables included age, gender, race, liver disease aetiology, antiretroviral therapy (cART), body mass index (BMI) and cause of death, when appropriate. Laboratory tests included CD4 + cell count, HIV RNA PCR, HCV RNA PCR and standard chemistry tests, including creatinine and bilirubin, for calculating MELD scores as follows: (MELD = [0.957 × Ln (creatinine mg/dL, maximum 4.0) + 0.378 × Ln (bilirubin mg/dL + 1.120 Ln (INR + 0.643] × 10.