End stage liver disease in co-infected patients
Research type
Research Study
Full title
Outcomes in patients with end stage liver disease co-infected with HIV and hepatitis B or C
IRAS ID
148993
Contact name
Charlotte Warren-Gash
Contact email
Sponsor organisation
UCL
Research summary
People who are infected with both HIV and viral hepatitis are more likely to develop end stage liver disease than those infected with hepatitis alone. This is partly because the development of liver disease is accelerated in co-infected patients, who also tend to respond less well to hepatitis treatment. Progression to end stage liver disease, including cirrhosis and liver cancer, is thus more rapid in co-infected patients and liver disease is now a major cause of death in HIV-infected individuals.
Historically, liver transplants were rarely successful in co-infected patients, in particular those infected with hepatitis C (rather than hepatitis B) in combination with HIV. This is mostly because the immunosuppressive drug therapies required to prevent organ rejection frequently resulted in infectious complications, leading to high death rates. Improved patient survival in HIV due to highly active antiretroviral therapy as well as recent advances in treatment of hepatitis C and prevention of opportunistic infections, mean that the option of liver transplantation must now be reconsidered in the co-infected population.
This study will assess current UK practice and transplant outcomes in co-infected patients and identify gaps in research and treatment in this cohort. The first part of the study will use routine clinical data already collected for the UK-CHIC study. The second part of the study will involve supplementing these data with
data obtained from medical records by treating clinicians at three UK transplant centres for any co-infected patient who has been referred for a transplant. Data will be incorporated into a pseudo-anonymised dataset to allow a richer analysis of outcomes for these patients.REC name
London - Surrey Borders Research Ethics Committee
REC reference
14/LO/1108
Date of REC Opinion
18 Jun 2014
REC opinion
Favourable Opinion