New agents to treat FXIII deficiency have become available in the last 5 years as well, and promise to normalize hemostasis and improve outcomes

for patients worldwide. “
“Hepatitis C virus infection is the major cause of end-stage liver disease and the major indication for transplantation (OLTX), including among HIV-HCV co-infected individuals. The age of HCV acquisition differs between haemophilic and non-haemophilic candidates, which may affect liver disease outcomes. The purpose of the study was to compare rates of pre- and post-OLTX BYL719 price mortality between co-infected haemophilic and non-haemophilic subjects without hepatocellular cancer participating in the Solid Organ Transplantation in HIV Study (HIV-TR). Clinical variables

included age, gender, race, liver disease aetiology, BMI, antiretroviral therapy, MELD score, CD4 +  cell count, HIV RNA PCR and HCV RNA PCR. Time to transplant, rejection and death were determined. Of 104 HIV-HCV positive subjects enrolled, 34 (32.7%) underwent liver transplantation, including 7 of 15 (46.7%) haemophilic and 27 of 89 (30.3%) non-haemophilic candidates. Although haemophilic subjects were younger, median 41 vs. 47 years, P = 0.01, they were more likely than non-haemophilic subjects to die pre-OLTX, 5 (33.3%) vs. 13 (14.6%), P = 0.03, and reached MELD = 25 marginally faster, 0.01 vs. 0.7 years, P = 0.06. PI3K inhibitor The groups did not differ in baseline click here BMI, CD4, detectable HIV RNA, detectable HCV RNA, time to post-OLTX death (P = 0.64), graft loss (P = 0.80), or treated rejection (P = 0.77). The rate of rejection was 14% vs. 36% at 1-year and 36% vs. 43% at 3-year, haemophilic vs. non-haemophilic subjects, respectively, and post-OLTX survival, 71% vs. 66% at 1-year and 38% vs. 53% at 3-year. Despite similar transplant outcomes, pretransplant mortality is higher among co-infected haemophilic than non-haemophilic candidates. Hepatitis C (HCV) is

the major cause of chronic liver disease and the leading indication for liver transplantation. HIV infection accelerates HCV-related liver disease [1-3], in part, through an HIV-induced TGF-β1-dependent increase in HCV replication [4], leading to questions regarding the advisability of liver transplantation in co-infected individuals. Despite HCV recurrence in virtually all recipients [2, 5, 6], transplantation is considered safe and effective in co-infected candidates [6-11], if they have demonstrated previous response to combination antiretroviral therapy (cART) [7]. The latter slows HCV progression [12-14], in part through suppression of HIV RNA and HIV-induced fibrosis-promoting cytokines [15, 16]. Increasingly, co-infected individuals are developing end-stage liver disease (ESLD) and undergoing transplantation, up to 10% of whom have haemophilia [5, 7]. Indeed, among men with haemophilia, HCV-related ESLD is the leading cause of death [1].