Autologous bone marrow cell transplantation in the treatment of HIV patients with compensated cirrhosis

Biosci Rep. 2020 Jun 26;40(6):BSR20191316. doi: 10.1042/BSR20191316.

Abstract

Liver stem cell therapy is a promising tool to improve decompensated liver cirrhosis (DLC). Especially in patients infected with human immunodeficiency virus (HIV), the condition of the liver may be aggravated by antiretroviral therapy. A total of 21 patients diagnosed with DLC and HIV infection were divided into two groups as follows: those who received (combination therapy group, 14 patients) and those who did not receive (routine therapy group, 7 patients) bone marrow cell transplantation through the portal vein. Two patients died of surgery-related complications in the combination therapy group. The results showed that the survival rate was 85.7% in the combination therapy group after 2 years of follow-up, which was significantly higher than the 14.3% in the conventional therapy group (P<0.01). After treatment, the liver function score decreased significantly in the combination therapy group at 1 (t = 4.276, P = 0.000), 3 (t = 9.153, P = 0.000), and 12 (t = 13.536, P = 0.000) months, the levels of albumin were significantly increased, and the total bilirubin level and prothrombin time were significantly reduced or shortened as compared with the routine therapy group (P<0.05 or <0.01). The white blood cell count, hemoglobin, platelet count, and CD4+ and CD8+ levels were significantly higher in the combination therapy group at different time points as compared with the routine therapy group (P<0.05 or <0.01). In summary, the combination therapy is effective in HIV-infected patients with DLC and useful for the recovery of liver function and cellular immune function but may increase the risk of severe complications after surgery.

Keywords: Autologous bone marrow cell transplantation; decompensated liver cirrhosis; human immunodeficiency virus; stem cell.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anti-HIV Agents / adverse effects
  • Anti-HIV Agents / therapeutic use*
  • Bone Marrow Transplantation* / adverse effects
  • Bone Marrow Transplantation* / mortality
  • Female
  • HIV Infections / diagnosis
  • HIV Infections / drug therapy*
  • HIV Infections / mortality
  • Humans
  • Liver Cirrhosis / diagnosis
  • Liver Cirrhosis / mortality
  • Liver Cirrhosis / surgery*
  • Male
  • Middle Aged
  • Postoperative Complications / etiology
  • Recovery of Function
  • Risk Factors
  • Splenectomy
  • Time Factors
  • Transplantation, Autologous
  • Treatment Outcome

Substances

  • Anti-HIV Agents