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HIV-positive adults on successful highly active antiretroviral therapy regimens are just as likely as HIV-negative adults to be alive one year after receiving a liver transplant, according to researchers from five U.S. transplant hospitals. Liver complications are a growing problem for people infected with HIV, particularly those who are coinfected with hepatitis B or C. However, most U.S. hospitals and health insurance plans generally do not cover liver transplant surgeries for HIV patients because of fears that HAART could hamper their recovery or that they will not live long enough to benefit from the transplant. This new study, however, found that after 12 months, 87.1% of the transplant patients studied were still alive, compared to the 86% survival rate of age-matched HIV-negative liver recipients. Patients who were unable to tolerate HAART after their transplants were the least likely to survive, and lower survival levels were seen in patients who had a postoperative CD4-cell count below 200, a viral load above 400 copies, or who were coinfected with hepatitis C. The researchers, reporting in the November 15 edition of Journal of Infectious Diseases, conclude that 'successful liver transplantation is possible in HIVinfected subjects.'
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