An Update on Heart Transplantation in Human Immunodeficiency Virus–Infected Patients

Agüero, Fernando; Castel, María Ángeles; Cocchi, Stefania; Moreno, Asunción; Mestres, Carlos A.; Cervera, Carlos; Pérez‐Villa, Félix; Tuset, Montserrat; Cartañá, Ramón; Manzardo, Christian; Guaraldi, Giovanni; Gatell, Josep M.; Miró, José M.

doi:10.1111/ajt.13496

Cited by 35 publications

(42 citation statements)

References 36 publications

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“…Unfortunately, more than half of transplant centers in the USA consider HIV+ serostatus as a contraindication [34], while the guidelines from the 2001 United Network for Organ Sharing (UNOS) states that asymptomatic HIV+ patients should not necessarily be excluded from transplant lists. The limited available data do not show any difference in the outcomes of heart transplant and LVAD in HIV+ patients on ART compared to the general population [34, 35]. …”

Section: Heart Failure and Myocardial Diseases In Hiv-infected Patientsmentioning

confidence: 99%

HIV Infection and Risk of Cardiovascular Diseases Beyond Coronary Artery Disease

Barnes

Lacson

Bahrami

2017

Curr Atheroscler Rep

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Purpose of Review Cardiovascular disease (CVD) increasingly afflicts people living with HIV (PLWH) in the contemporary era of antiretroviral therapy (ART). Coronary artery disease (CAD) is the most widely studied cardiovascular problem in PLWH; however, less is known about other clinically relevant subtypes of CVD such as heart failure (HF), cerebrovascular disease, sudden cardiac death, pericardial diseases, and pulmonary hypertension. This paper reviews evidence of other subtypes of CVD as emerging issues in the post-ART era. Recent Findings Recent studies have shown that PLWH have higher risk of HF as well as subclinical impairment of left ventricular (LV) mechanics (systolic and diastolic dysfunction) and myocardial abnormalities (fibrosis and steatosis). The underlying mechanisms, however, are not well-understood. A few studies have also shown higher rates of atrial fibrillation and sudden cardiac death in PLWH. Ischemic stroke is the most common stroke type in the post-ART era, with underlying mechanisms like those identified in CAD: chronic inflammation and associated vasculopathy. Studies of great vessels (carotid artery and aorta) and peripheral arterial disease show heterogeneous results. Small subclinical pericardial effusions are common in PLWH in post-ART era. Pulmonary hypertension continues to be an underdiagnosed and potentially fatal complication of HIV infection. Summary PLWH remain at higher risk for all types of CVD including heart failure, stroke, and arrhythmias in the post-ART era. Chronic inflammation may play an important role in this increased risk. More studies are needed to further elucidate the extent of non-coronary CVD in PLWH and the underlying mechanisms for them.

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Section: Heart Failure and Myocardial Diseases In Hiv-infected Patientsmentioning

confidence: 99%

HIV Infection and Risk of Cardiovascular Diseases Beyond Coronary Artery Disease

Barnes

Lacson

Bahrami

2017

Curr Atheroscler Rep

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“…7,8 In the c-ART era, the prevalence of systolic dysfunction in HIV+ patients is estimated to be ≈8% and prevalence of clinical heart failure to be ≈3%. 7,8 In the c-ART era, the prevalence of systolic dysfunction in HIV+ patients is estimated to be ≈8% and prevalence of clinical heart failure to be ≈3%.…”

Section: Discussionmentioning

confidence: 99%

“…3 Previous retrospective case series have shown that heart transplantation (HT) is an effective therapy in carefully selected HIV+ patients. 6,7 This is likely due to limited literature about the outcomes of HT in HIV+ patients including survival, the prevalence of cardiac allograft vasculopathy (CAV), incidence of posttransplant malignancy, and rejection rates. 6,7 This is likely due to limited literature about the outcomes of HT in HIV+ patients including survival, the prevalence of cardiac allograft vasculopathy (CAV), incidence of posttransplant malignancy, and rejection rates.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of heart transplantation in patients with human immunodeficiency virus

Madan

Patel

Saeed

et al. 2019

American Journal of Transplantation

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Human immunodeficiency virus-positive (HIV+) patients are not routinely offered heart transplantation (HT) due to lack of adequate outcomes data. Between January 2004 and March 2017, we identified 41 adult (≥18 years) HT recipients with known HIV+ serostatus at the time of transplant in UNOS and evaluated post-HT outcomes.Overall, Kaplan-Meier (KM) estimates of survival at 1 and 5 years were 85.9% and

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“…In North America, between 2003 and 2011, there has been a 10‐fold increase in the number of kidney transplants in patients with HIV infection . Similarly encouraging outcomes are seen in liver and heart recipients co‐infected with HIV and hepatitis B virus . In addition, the recent positive experience with carefully selected South‐African HIV‐infected patients who received kidneys from HIV‐infected donors prompted changes to the US’ legislation, allowing the development of clinical research and eventually a revision of the organ donation and transplantation regulation .…”

Section: Introductionmentioning

confidence: 99%

Sexual acquisition of HIV infection after solid organ transplantation: Late presentation and potentially fatal complications

Cristelli

Mazolin

Manzardo

et al. 2018

Transplant Infectious Dis

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An Update on Heart Transplantation in Human Immunodeficiency Virus–Infected Patients

Cited by 35 publications

References 36 publications

HIV Infection and Risk of Cardiovascular Diseases Beyond Coronary Artery Disease

HIV Infection and Risk of Cardiovascular Diseases Beyond Coronary Artery Disease

Outcomes of heart transplantation in patients with human immunodeficiency virus

Sexual acquisition of HIV infection after solid organ transplantation: Late presentation and potentially fatal complications

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