An Update on Heart Transplantation in Human Immunodeficiency Virus–Infected Patients |
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Authors: | A Moreno C A Mestres C Cervera F Pérez‐Villa M Tuset R Cartañà C Manzardo G Guaraldi J M Gatell J M Miró |
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Institution: | 1. Infectious Diseases Service, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain;2. Cardiovascular Surgery Department, Thorax Institute Service, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain;3. Heart Failure and Heart Transplant Unit, Cardiology Department, Thorax Institut, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain;4. Pharmacy Department, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain;5. Clinic of Infectious Diseases, Department of Internal Medicine and Medical Specialties, University of Modena and Reggio Emilia, Policlinico Hospital, Modena, Italy |
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Abstract: | Cardiovascular diseases have become a significant cause of morbidity in patients with human immunodeficiency virus (HIV) infection. Heart transplantation (HT) is a well‐established treatment of end‐stage heart failure (ESHF) and is performed in selected HIV‐infected patients in developed countries. Few data are available on the prognosis of HIV‐infected patients undergoing HT in the era of combined antiretroviral therapy (cART) because current evidence is limited to small retrospective cohorts, case series, and case reports. Many HT centers consider HIV infection to be a contraindication for HT; however, in the era of cART, HT recipients with HIV infection seem to achieve satisfactory outcomes without developing HIV‐related events. Consequently, selected HIV‐infected patients with ESHF who are taking effective cART should be considered candidates for HT. The present review provides epidemiological data on ESHF in HIV‐infected patients from all published experience on HT in HIV‐infected patients since the beginning of the epidemic. The practical management of these patients is discussed, with emphasis on the challenging issues that must be addressed in the pretransplant (including HIV criteria) and posttransplant periods. Finally, proposals are made for future management and research priorities. |
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Keywords: | clinical research/practice heart transplantation/cardiology infectious disease heart (native) function/dysfunction infection and infectious agents viral: human immunodeficiency virus (HIV) / acquired immunodeficiency syndrome (AIDS) heart (allograft) function/dysfunction |
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