New York Times Spotlights Debate Surrounding Liver Transplants for HIV-Positive People
Offering liver transplants to people with HIV was considered "unthinkable" a few years ago, but because advances in AIDS drugs have improved the prognosis for these patients, many doctors and AIDS activists now say that it is "not ethical to deny transplants" to people with HIV, the New York Times reports. The debate surrounding liver transplants for people with HIV first arose because many of those infected with HIV are also co-infected with either hepatitis C or hepatitis B, both of which are diseases affecting the liver. Fifteen percent of all HIV-positive people are also infected with hepatitis C, and 40% of HIV-positive gay men are believed to have hepatitis B, according to the Times. The United Network for Organ Sharing, which maintains the national liver transplant waiting list, estimates that there are 18,646 people in the United States who are waiting for a new liver. UNOS guidelines state that an HIV-positive, asymptomatic patient "should not necessarily be excluded from candidacy for organ transplantation, but should be advised that he or she may be at increased risk of morbidity and mortality because of immunosuppressive therapy." Only 33 liver transplants were performed in HIV-positive patients between 1988 and 2000, and many insurance companies as well as some doctors say that the procedure is still "experimental." However, Dr. John Fung, a transplant surgeon at the University of Pittsburgh, said that the one-year survival rates of liver transplants among people with HIV is about 90%, which is "comparable" to survival rates among patients without HIV. In the past four years, 14 liver transplants have been performed in HIV-positive patients, and 12 of those patients are still alive (Stryker, New York Times, 12/11).This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.