There's a great deal of attention paid to hepatitis and HIV, but I've developed something called nodular regenerative hyperplasia that is probably related to HIV according to a recent French study I unearthed myself. I've had HIV for 26 years, I'm a 53-year-old female, and I'm finding that several of my organs including my kidneys are showing problems. (I was diagnosed with HIVAN a couple of years ago.) However, the NRH is by far the most dangerous thing right now because I've developed portal hypertension and spent the better part of a month last year in the hospital being treated for bleeding esophageal varices. More recently, I've developed a stomach ulcer. Since my liver problem is relatively rare and the liver specialist I'm seeing has not had any experience with NRH and HIV, it's very hard for me to get a fix on what my prognosis is. I've been told that I could need a liver transplant at some point, but I get the feeling that an HIV+ person might not be considered for a transplant and that in any event one has to be close to death to get one. How do they define "close to death?" Anyway, if you have any information that would be helpful, I'd appreciate a reply. Thanks, Sally

Nodular regenerative hyperplasia is an extremely rare condition, most recently described in HIV-infected patients. At first there was some concern about a relationship between this disease and ddI, but more recent work does not suggest this association. Some preliminary data presented at AASLD in the fall of 2007 suggested that there may be an associated clotting problem. In general, it is a poorly understood process. I agree that with portal hypertension and bleeding varices, you may need to be on a list for a transplant.

I have included a few websites for you to get more information about transplants in HIV infected persons:

Specific site and study information can be found at http:// www.HIVTransplant.com or http://www.clinicaltrials.gov/

This may be the reference you are referring to: V Mallet, P Blanchard, V Vekarre, and others. Nodular regenerative hyperplasia is a new cause of chronic liver disease in HIV-infected patients. AIDS 21(2): 187-192. January 11, 2007.

Best regards,