The widespread availability of potent anti-HIV therapy, commonly called ART or HAART, has led to tremendous increases in life expectancy of HIV-positive people, particularly in high-income countries such as Canada. Despite this good news, some HIV-positive people may face other long-term problems as they age, including liver and kidney damage arising from co-infection with hepatitis B and C viruses, diabetes and higher-than-normal blood pressure.
In the time before HAART, organ transplants were attempted in HIV-positive people. In general, HIV-positive people who received transplants in the pre-HAART era appeared to have shortened survival. In the present era, doctors in the United States and Western Europe have gained experience conducting successful liver and kidney transplants in HIV-positive people.
In Canada, until recently, HIV-positive people were routinely excluded from even the possibility of receiving a transplanted organ. However, in British Columbia, Ontario and Quebec, HIV-positive people will now be considered for the waiting lists for organ transplants. Hopefully in the near future such transplants will become routine when needed.
In this issue of TreatmentUpdate, we feature research on several issues related to organ transplantation mostly in the setting of HIV infection.