Successful Cardiac Transplantation in an HIV-1–Infected Patient with Advanced Disease

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Abstract
Advances in the management of human immunodeficiency virus (HIV) infection — specifically, the introduction of highly active antiretroviral therapy — have dramatically delayed the progression of disease, enhanced immunologic function, and reduced mortality.1 Coincident with these trends has been an increase in mortality due to end-organ failure, rather than from other life-threatening causes related to HIV.2 Therapy for end-organ failure has generally been supportive, but during the past few years, a small number of solid-organ transplantations, mostly of kidneys and livers, in patients known to be HIV-positive have been reported.3-5 Recently, on both ethical and scientific grounds, some have called for solid-organ transplantation in HIV-positive patients to be initiated at major transplantation centers and to be viewed similarly to transplantation in other patients.6,7 We report the 24-month follow-up of a patient infected with HIV type 1 (HIV-1) who underwent cardiac transplantation when his serologic status was known.