Study Will Follow Outcomes of HIV-to-HIV Liver Transplants

Months after announcing that it will sponsor a study following the safety of HIV-to-HIV kidney transplantation, the National Institutes of Health’s National Institute of Allergy and Infectious Diseases (NIAID) will sponsor the HOPE in Action Multicenter Liver Study to determine the safety of liver transplantation between people living with HIV.

These types of transplants became legal in the United States in 2013 with the passing of the HIV Organ Policy Equity Act, which allows the qualified transplant teams to transplant organs from donors with HIV to recipients with HIV and end-stage organ failure. The first study, the HOPE in Action Multicenter Kidney Study, announced in May 2018, will follow the outcomes of 160 kidney transplants, with half receiving kidneys from infected donors and half receiving kidneys from uninfected donors.

The results of these studies have important implications as people living with HIV have a higher risk of end-stage liver and kidney diseases as a result of the virus and common comorbidities, such as hepatitis B and C viruses, hypertension, and diabetes.

“Should liver transplants between people with HIV be shown to be safe and effective through this research, the donor pool will expand—saving lives and reducing the time that both HIV-negative and HIV-positive people spend on an organ transplant waiting list,” said Christine Durand, MD, associate professor of medicine at Johns Hopkins University and principal investigator of the HOPE in Action Multicenter Liver Study, in a statement.

The study will follow 80 liver transplant recipients with HIV. Half will receive a liver from an HIV-positive donor and half will receive livers from an HIV-negative donor. According to NIAID, 8% of these recipients will also require a simultaneous kidney transplant and will be eligible to receive both organs from the sane donor.

Researchers will observe recipients for signs of organ rejection, organ failure, failure of previously effective anti-HIV medications, and HIV-associated complications. Psychological and social responses will also be monitored, as well as changes in HIV reservoirs and the potential of developing HIV superinfection.