Advances in Liver Transplantation for Persons with Human Immunodeficiency Infection.

Purpose of review: Advanced liver disease is a leading cause of non-AIDS-related morbidity and mortality in persons with HIV on antiretroviral therapy. As a result, persons with HIV are increasingly seeking liver transplantation.

Recent findings: With the availability of direct-acting antiviral hepatitis C therapies, there has been a shift in the indications for liver transplantation in persons with HIV, with non-alcoholic fatty liver disease now the leading indication over hepatitis C infection. Additionally, liver transplant outcomes have improved in persons with HIV-hepatitis C co-infection persons with HIV. Preliminary results of HIV-to-HIV liver transplantation show acceptable results although rates of post-transplant infections and malignancies are areas of concern.

Summary: Future studies of liver transplantation in persons with HIV should focus on long-term outcomes, especially in the context of steatohepatitis and co-existing morbidities like diabetes, hyperlipidemia, and cardiovascular disease and other prevalent diseases in an aging population.