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Correspondence
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Volume 345:1781 December 13, 2001 Number 24
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Fibrosing Cholestatic Hepatitis after Liver Transplantation in a Patient with Hepatitis C and HIV Infection

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To the Editor: A small but growing number of patients with human immunodeficiency virus (HIV) infection undergo orthotopic liver transplantation for complications of intercurrent infection with hepatitis B virus (HBV), hepatitis C virus (HCV), or both. HCV invariably reinfects liver allografts, typically causing a lobular hepatitis, and is reasonably well tolerated in the short term. If hepatitis B recurs after transplantation, it frequently causes devastating disease characterized by a rapidly progressive pathological process termed fibrosing cholestatic hepatitis, resulting in liver failure.1 The postulated mechanism of this process is unimpeded viral replication mediated by immunosuppression in the transplant recipient. HIV has . . . [Full Text of this Article]

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