TABLE 1.
Baseline characteristics and comparative analysis of liver transplant recipients with HIV+/HCV+ coinfection in the United States in the DAA era (2014–2019), and monoinfected and uninfected DAA recipients and HIV+/HCV+-coinfected pre-DAA recipients
| DAA (2014–2019) (N = 40 554) | Pre-DAA (2008–2012) | ||||
|---|---|---|---|---|---|
| HIV+/HCV+a (n = 124) | HIV+/HCV− (n = 147) | HIV−/HCV+ (n = 11 231) | HIV−/HCV−(n = 29 052) | HIV+/HCV+ (n = 68) | |
| Donor | |||||
| Age (y) | 39.0 (28.0–51.5) | 38.0 (25.0–53.0) | 40.0 (28.0–53.0) | 41.0 (28.0–54.0) | 40.5 (24.5–51.5) |
| BMI (kg/m2) | 25.8 (23.5–30.0) | 27.1 (23.3–32.9) | 27.0 (23.6–31.2) | 27.0 (23.5–31.3) | 25.7 (22.2–30.9) |
| Male gender | 76 (61.3) | 93 (63.3) | 6815 (60.7) | 17 273 (59.5) | 40 (58.8) |
| Caucasian race | 73 (58.9) | 88 (59.9) | 7518 (66.9) | 18 758 (64.6) | 38 (55.9) |
| Diabetes | 6 (4.8) | 13 (8.8) | 1333 (11.9)* | 3350 (11.5)* | 8 (11.8) |
| HIV+b (HOPE Act) | 24 (19.4) | 19 (12.9) | 2 (0.01)*** | 1 (0.01)*** | 0 (0.0)*** |
| DCD | 8 (6.5) | 12 (8.2) | 815 (7.3) | 2038 (7.0) | 4 (5.9) |
| Cold ischemic time (h) | 6.1 (4.8–7.9) | 5.5 (4.5–7.0) | 5.8 (4.5–7.2) | 5.6 (4.3–7.0)** | 6.0 (5.1–7.3) |
| DRIc | 1.76 (1.55–2.06) | 1.71 (1.51–2.09) | 1.71 (1.51–2.04) | 1.74 (1.53–2.10) | 1.71 (1.57–1.91) |
| Recipient | |||||
| Age (y) | 57.0 (52.5–62.0) | 55.0 (49.0–60.0)* | 60.0 (56.0–64.0)*** | 57.0 (48.0–64.0) | 54.0 (49.5–57.0)*** |
| Male gender | 92 (74.2) | 120 (81.6) | 8422 (75.0) | 17 856 (61.5)** | 52 (76.5) |
| Caucasian race | 58 (46.8) | 82 (55.8) | 7570 (67.4)*** | 21 118 (72.7)*** | 42 (61.8)* |
| BMI (kg/m2) | 26.7 (23.6–31.9) | 26.1 (23.2–30.3) | 28.0 (24.7–31.9) | 28.2 (24.5–32.6)* | 26.6 (23.4–30.0) |
| Posttransplant LOS (d) | 10.0 (7.0–14.0) | 10.0 (7.0–19.0) | 9.0 (6.0–15.0) | 10.0 (7.0–17.0) | 9.0 (7.0–13.0) |
| Waiting list time (d) | 230.5 (48.0–522.0) | 91.0 (17.0–243.0)*** | 196.0 (45.0–215.0) | 78.0 (13.0–264.0)*** | 99.0 (37.5–256.5)** |
| Diabetes | 27 (21.8) | 42 (28.6) | 3001 (26.7) | 8794 (30.3)* | 12 (17.7) |
| MELD score | 17.0 (10.0–24.0) | 22.0 (14.0–31.0)** | 16.0 (10.0–25.0) | 24.0 (16.0–33.0)*** | 18.0 (12.0–24.0) |
| Life support requirement | 3 (2.4) | 15 (10.2)* | 592 (5.3) | 2923 (10.1)** | 1 (1.5) |
| ICU | 6 (4.8) | 18 (12.2)* | 934 (8.3) | 4759 (16.4)** | 4 (5.9) |
| Dialysis requirement | 12 (9.7) | 18 (12.2) | 1296 (11.5) | 5150 (17.7)* | 2 (2.9) |
| Ascites (mild or worse) | 77 (62.1) | 105 (71.4) | 7232 (64.4) | 22 228 (76.5)*** | 51 (75.0) |
| Hepatic encephalopathy (grade 1 or worse) | 56 (45.2) | 92 (62.6)** | 6067 (54.0)* | 19 155 (65.9)*** | 40 (58.8) |
| PVT | 13 (10.5) | 28 (19.0)* | 1627 (14.5) | 4014 (13.8) | 6 (8.8) |
| HCC | 52 (41.9) | 32 (21.7)*** | 6387 (56.9)** | 5803 (20.0)*** | 29 (42.6) |
aHIV+/HCV+ group in DAA era are compared with all other groups through pairwise comparisons of P value from chi-squared test for categorical variables and 2-sample Wilcoxon rank test for continuous variables (all continuous variables failed the Shapiro-Wilk normality test).
bAs per positive HIV antibody, HIV NAT, or HIV antigen/antibody combination tests, by which OPTN allocate donors through the HOPE Act. All data were completely apart from the following missing data: donor variables = diabetes, n = 2105; cold ischemic time, n = 147; BMI, n = 53. Recipient variables = diabetes, n = 35; BMI, n = 9; length of stay, n = 491; days on waitlist, n = 1; ICU, n = 1; life support requirement, n = 1; portal vein thrombosis, n = 173; hepatic encephalopathy, n = 1; dialysis, n = 114; ascites, n = 1. Missing values of continuous variables were ignored, while missing values of categorical variables were assumed to be negative.
cCalculated by the DRI formula provided by Feng et al.24
Values are n (%) or median (interquartile range).
Significance codes: ***P < 0.001; **0.001 < P ≤ 0.01; *0.01 < P ≤ 0.05 (all other P > 0.05).
BMI, body mass index; DAA, direct-acting antiviral; DCD, donation after circulatory death; DRI, donor risk index; HCC, hepatocellular carcinoma; HCV, hepatitis C virus; HOPE, HIV Organ Policy Equity; ICU, intensive care unit; LOS, length of stay; MELD, Model For End-Stage Liver Disease; NAT, nucleic acid test; OPTN, Organ for Procurement and Transplantation Network; PVT, portal vein thrombosis.