BACKGROUND: Human immunodeficiency virus (HIV) infection has evolved from a highly stigmatized disease with certain progression to acquired immunodeficiency syndrome (AIDS) to a chronic disease affecting over 1 million Americans. With the success of current anti-retroviral therapies, cardiovascular disease, including advanced heart failure (HF), will be a major cause of morbidity and mortality in this population. METHODS: A survey concerning heart transplantation (HT) and left ventricular assist device (LVAD) implantation attitudes and outcomes in HIV-infected patients was distributed to 103 American and 9 Canadian HT centers via fax, e-mail or telephone. RESULTS: Eighty-nine centers (79%) responded. Eighteen HTs were performed in HIV(+) patients with 1-, 2- and 5-year survival of 100%, 100% and 63%, respectively. Eighty-two centers (92%) have never performed HT in HIV(+) patients and 51 centers (57%) marked HIV(+) status as a contraindication. Rationales for contraindication included: (1) high-risk patients should be avoided given the scarcity of organ supply (59%); (2) immunosuppression required for HT may induce progression to AIDS (51%); and (3) drug interactions may worsen patients' clinical outcomes (49%). Thirty-five left ventricular assist device (LVAD) implantations in HIV(+) patients were reported. Sixty-eight centers (76%) have never implanted an LVAD in an HIV(+) patient and 21 centers (20%) marked HIV(+) status as a contraindication, of which 61% indicated concern for device-related infection. CONCLUSIONS: Most centers either explicitly consider HIV(+) status as a contraindication for or have never treated HIV(+) patients with advanced HF therapy. Our findings suggest unequal access to care and underscore the need to educate cardiovascular health-care providers on progress made with HIV therapies.
BACKGROUND: Human immunodeficiency virus (HIV) infection has evolved from a highly stigmatized disease with certain progression to acquired immunodeficiency syndrome (AIDS) to a chronic disease affecting over 1 million Americans. With the success of current anti-retroviral therapies, cardiovascular disease, including advanced heart failure (HF), will be a major cause of morbidity and mortality in this population. METHODS: A survey concerning heart transplantation (HT) and left ventricular assist device (LVAD) implantation attitudes and outcomes in HIV-infectedpatients was distributed to 103 American and 9 Canadian HT centers via fax, e-mail or telephone. RESULTS: Eighty-nine centers (79%) responded. Eighteen HTs were performed in HIV(+) patients with 1-, 2- and 5-year survival of 100%, 100% and 63%, respectively. Eighty-two centers (92%) have never performed HT in HIV(+) patients and 51 centers (57%) marked HIV(+) status as a contraindication. Rationales for contraindication included: (1) high-risk patients should be avoided given the scarcity of organ supply (59%); (2) immunosuppression required for HT may induce progression to AIDS (51%); and (3) drug interactions may worsen patients' clinical outcomes (49%). Thirty-five left ventricular assist device (LVAD) implantations in HIV(+) patients were reported. Sixty-eight centers (76%) have never implanted an LVAD in an HIV(+) patient and 21 centers (20%) marked HIV(+) status as a contraindication, of which 61% indicated concern for device-related infection. CONCLUSIONS: Most centers either explicitly consider HIV(+) status as a contraindication for or have never treated HIV(+) patients with advanced HF therapy. Our findings suggest unequal access to care and underscore the need to educate cardiovascular health-care providers on progress made with HIV therapies.
Authors: Sarah E Van Pilsum Rasmussen; Mary Grace Bowring; Ashton A Shaffer; Macey L Henderson; Allan Massie; Aaron A R Tobian; Dorry L Segev; Christine M Durand Journal: Clin Transplant Date: 2018-08-31 Impact factor: 2.863
Authors: Antonio Hernandez Conte; Michelle M Kittleson; Deanna Dilibero; W David Hardy; Jon A Kobashigawa; Fardad Esmailian Journal: Tex Heart Inst J Date: 2016-02-01
Authors: Shanti M Seaman; Sarah E Van Pilsum Rasmussen; Anh Q Nguyen; Samantha E Halpern; Susan You; Madeleine M Waldram; Saad K Anjum; Mary Grace Bowring; Abimereki D Muzaale; Darin B Ostrander; Diane Brown; Allan B Massie; Aaron A R Tobian; Macey L Henderson; Faith E Fletcher; Burke Smith; Ada Chao; Nishita Gorupati; Katya Prakash; Saima Aslam; Dong H Lee; Varvara Kirchner; Timothy L Pruett; Ghady Haidar; Kailey Hughes; Maricar Malinis; Sonya Trinh; Dorry L Segev; Jeremy Sugarman; Christine M Durand Journal: J Acquir Immune Defic Syndr Date: 2020-09-01 Impact factor: 3.771
Authors: Kaku So-Armah; Laura A Benjamin; Gerald S Bloomfield; Matthew J Feinstein; Priscilla Hsue; Benson Njuguna; Matthew S Freiberg Journal: Lancet HIV Date: 2020-04 Impact factor: 16.070
Authors: Raza M Alvi; Anne M Neilan; Noor Tariq; Magid Awadalla; Adam Rokicki; Malek Hassan; Maryam Afshar; Connor P Mulligan; Virginia A Triant; Markella V Zanni; Tomas G Neilan Journal: J Am Heart Assoc Date: 2018-09-18 Impact factor: 5.501