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

Area of Science:

• Cardiology
• Infectious Diseases
• Transplantation Medicine

Background:

• Cardiovascular diseases are a major cause of illness in human immunodeficiency virus (HIV)-infected patients.
• Heart transplantation (HT) is a treatment for end-stage heart failure (ESHF), including in select HIV-infected individuals.
• Limited data exist on HT outcomes in HIV-infected patients on combined antiretroviral therapy (cART).

Purpose of the Study:

• To review epidemiological data on ESHF in HIV-infected patients.
• To discuss practical management strategies for HIV-infected patients undergoing HT.
• To identify pre- and post-transplant challenges and future research priorities.

Main Methods:

• Systematic review of published literature on HT in HIV-infected patients.
• Analysis of epidemiological data since the HIV epidemic's onset.
• Discussion of clinical management based on current evidence.

Main Results:

• HIV-infected patients on effective cART demonstrate satisfactory outcomes post-HT.
• HIV-related events are not prevalent in HT recipients with HIV on cART.
• Many centers still consider HIV a contraindication, despite positive outcomes.

Conclusions:

• Selected HIV-infected patients with ESHF on effective cART should be considered for HT.
• Careful pre- and post-transplant management is crucial for successful outcomes.
• Further research is needed to optimize HT protocols for this population.