Cardiac transplantation in HIV positive patients: a narrative review.

ABSTRACT Prior to the introduction of highly active antiretroviral therapy, patients infected with human immunodeficiency virus (HIV) experienced poor prognosis including high rates of opportunistic infections, rapid progression to Acquired Immuno-Deficiency Syndrome (AIDS), and significant mortality. Increased life expectancy following therapeutic improvements has led to an increase in other chronic diseases for these patients, including cardiovascular disease, and in particular, end-stage heart failure. Historically, HIV infection was deemed an absolute contraindication for transplantation. Since the development of highly active antiretroviral therapy however, life expectancy for HIV positive patients has significantly improved. In addition, there is less incidence of opportunistic infections and the current antiretrovirals have an improved toxicity profile. Despite this, the current status of cardiac transplants in HIV positive patients remains unclear. With this in mind, we conducted a narrative review on cardiac transplantation in patients with HIV.