Research Group

  • Dr Jose Miro, Principal Investigator
  • Dr Christian Brander, Collaborator
  • Dr Antonio Rimola, Collaborator
  • Dr Angeles Muñoz, Collaborator
  • Dr Todd Allen, Collaborator
  • Dr Susanna Naggie, Collaborator
  • Dr Alberto Sanchez-Fueyo, Collaborator
  • Dr Sandra Silva Arrieta, Research Assistant
  • Dr Christian Manzardo, Research Assistant

Location

  • Hospital clinic – IDIBAPS, Barcelona, Spain

Title

  • Biological Factors Influencing Outcome HCV/HIV Co-Infected Liver Transplant Recipients

Currently, human immunodeficiency virus (HIV) infection can be very well controlled by combined antiretroviral medication and the life-span of virologically suppressed HIV-infected patients is almost similar to the uninfected population. However,
HIV/hepatitis C virus (HCV) co-infected patients can die of liver HCV cirrhosis, and liver transplantation is the only therapeutic alternative. The short-term outcome of liver transplantation in HCV/HIV co-infected patients is similar to the HIV uninfected recipients. However, as HCV reinfection of the implanted liver is universal in liver transplantation and impacts graft survival and liver transplantation outcome, the mid-long term outcome of HCV/HIV co-infected recipients is compromised by a more severe and aggressive HCV recurrence than of HIV-negative recipients. Paradoxically, some HCV/HIV co-infected individuals can clear the HCV infection entirely, though mechanisms that remain unknown. Furthermore, although HIV-infected liver transplant recipients are immune suppressed by their HIV infection, the rate of strong organ rejection is also almost two-fold higher than in the uninfected population. The biological mechanisms (immunological, host genetic and virological) that are influencing these outcomes of liver transplantation in HCV/HIV co-infected recipients remain poorly understood. This proposal is unique because we can access blood and tissue samples from HCV/HIV co-infected liver transplant patients and compare them to an HCV-monoinfected cohort currently under investigation. As a consequence, we will be able to compare for the first time the immunological (allo- and HCV-specific T cell responses), host genetic (HLA and HCV-related polymorphisms) and virological (HCV sequence evolution) parameters in HIV-infected and uninfected HCV-positive liver transplant recipients in order to better understand these outcomes. Thereby, present proposal has the potential to provide novel ways to optimize organ usage and to improve the management of outcomes in liver transplantation in HCV-infected patients.

Final Report