Related Experiment Video

Updated: Apr 28, 2026

Oral Combinational Antiretroviral Treatment in HIV-1 Infected Humanized Mice
06:07

Oral Combinational Antiretroviral Treatment in HIV-1 Infected Humanized Mice

Published on: October 6, 2022

2.2K

Advanced heart failure in patients infected with human immunodeficiency virus: is there equal access to care?

Nir Uriel1, Nadav Nahumi2, Paolo C Colombo2

  • 1Division of Cardiology, University of Chicago, Chicago, Illinois.

The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation
|June 16, 2014
PubMed

Insights

Most heart centers avoid treating advanced heart failure in HIV patients, citing risks and contraindications. This highlights unequal access to care and the need for provider education on modern HIV therapies.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Transplantation Medicine

Background:

  • Human immunodeficiency virus (HIV) infection is now a chronic condition for over 1 million Americans.
  • Cardiovascular disease, including advanced heart failure (HF), is a leading cause of morbidity and mortality in the HIV-positive population.
  • Advances in antiretroviral therapy have improved outcomes for HIV patients, necessitating re-evaluation of treatment guidelines for comorbidities.

Purpose of the Study:

  • To assess current attitudes and practices regarding advanced heart failure therapies in human immunodeficiency virus (HIV)-infected patients.
  • To investigate the utilization and perceived contraindications for heart transplantation (HT) and left ventricular assist device (LVAD) implantation in HIV-positive individuals.
  • To identify barriers to care for advanced heart failure in the HIV-positive population.

Main Methods:

  • A survey was distributed to 103 American and 9 Canadian heart transplantation (HT) centers.
  • The survey collected data on attitudes and outcomes related to heart transplantation (HT) and left ventricular assist device (LVAD) implantation in HIV-infected patients.
  • Responses were gathered via fax, email, or telephone.

Main Results:

  • Only 18 heart transplants (HTs) were performed in HIV-positive patients, with high short-term survival but limited long-term data (63% at 5 years).
  • A significant majority of centers (92%) have never performed HT in HIV-positive patients, with 57% citing HIV status as a contraindication due to organ scarcity, immunosuppression concerns, or drug interactions.
  • Similarly, 76% of centers have never implanted a left ventricular assist device (LVAD) in HIV-positive patients, with 20% listing HIV as a contraindication, primarily due to concerns about device-related infections.

Conclusions:

  • The majority of heart centers either contraindicate or have no experience treating advanced heart failure in HIV-positive patients.
  • These findings indicate disparities in access to advanced cardiovascular care for individuals living with HIV.
  • There is a critical need for enhanced education among cardiovascular healthcare providers regarding the efficacy and safety of modern HIV therapies and their implications for advanced HF treatment.
Abstract

Keywords:
contraindicationheart transplantationhuman immunodeficiency virussurveyventricular assist device

More Related Videos

Exergaming in Older People Living with HIV Improves Balance, Mobility and Ameliorates Some Aspects of Frailty07:27

Exergaming in Older People Living with HIV Improves Balance, Mobility and Ameliorates Some Aspects of Frailty

Published on: October 6, 2016

12.2K
An Affordable HIV-1 Drug Resistance Monitoring Method for Resource Limited Settings19:57

An Affordable HIV-1 Drug Resistance Monitoring Method for Resource Limited Settings

Published on: March 30, 2014

19.2K

Related Concept Videos

Sexually Transmitted Infections01:26

Sexually Transmitted Infections

Sexually transmitted infections (STIs) are diseases transmitted primarily through unsafe sexual interactions. Bacteria, viruses, or parasites cause them and can result in severe health complications if untreated.ChlamydiaThe bacterium Chlamydia trachomatis is responsible for the disease Chlamydia, the most common STI in the United States. This peculiar pathogen requires human cells to reproduce, residing intracellularly. The initial infection often goes unnoticed because it typically does not...
1.9K
Heart Failure VI: Adjunct Therapies01:22

Heart Failure VI: Adjunct Therapies

Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
631
Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
621
Immunodeficiency Diseases01:25

Immunodeficiency Diseases

Immunodeficiency disorders are conditions in which the immune system's ability to fight infectious disease and cancer is compromised or entirely absent. The immune system comprises a complex network of cells, tissues, and organs that work together to protect the body from potentially harmful invaders. When this system is deficient or not functioning properly, it leaves the body susceptible to infections, diseases, or other complications.
There are three main causes of immunodeficiency...
3.5K
Heart Failure I: Introduction01:27

Heart Failure I: Introduction

Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
1.6K
Retrovirus Life Cycles01:10

Retrovirus Life Cycles

Retroviruses have a single-stranded RNA genome that undergoes a special form of replication. Once the retrovirus has entered the host cell, an enzyme called reverse transcriptase synthesizes double-stranded DNA from the retroviral RNA genome. This DNA copy of the genome is then integrated into the host’s genome inside the nucleus via an enzyme called integrase. Consequently, the retroviral genome is transcribed into RNA whenever the host’s genome is transcribed, allowing the...
42.9K