Adekunle Ruth O, Rodrigues Moreno, Durand Christine M
Division of Infectious Diseases, Medical University of South Carolina, 135 Rutledge Avenue, 12th Floor, MSC 752, Charleston, SC, 29425, USA.
Department of Medicine, Johns Hopkins University School of Medicine, 2000 E. Monument Street Room 103, Baltimore, MD, 21205, USA.
Curr HIV/AIDS Rep. 2025 Mar 21;22(1):26. doi: 10.1007/s11904-025-00735-2.
Antiretroviral therapy has significantly improved the life expectancy of people with HIV (PWH), leading to an increased prevalence of comorbidities such as end-stage organ diseases. PWH with end-stage disease face a significantly higher risk of mortality compared to those without HIV, highlighting the urgent need to improve access to organ transplantation for this vulnerable group. This review examines barriers to organ transplantation for PWH, utilizing a modified five A's model (acceptability, availability, accessibility, affordability, accommodation).
Despite comparable post-transplant outcomes to the general population, PWH are less likely to receive organ transplants. The HIV Organ Policy and Equity (HOPE) Act has expanded the donor pool by permitting organ transplants from donors with HIV to recipients with HIV. However, factors limiting expansion include policy, logistical constraints, and HIV-related stigma. Despite pivotal advancements in HIV organ transplantation, multilevel challenges continue to limit access for PWH. Addressing these barriers is essential to ensuring equitable access to this life-saving therapy.
抗逆转录病毒疗法显著提高了人类免疫缺陷病毒（HIV）感染者（PWH）的预期寿命，导致诸如终末期器官疾病等合并症的患病率增加。与未感染HIV的人相比，患有终末期疾病的PWH面临着显著更高的死亡风险，这凸显了迫切需要改善这一弱势群体获得器官移植的机会。本综述利用改良的5A模型（可接受性、可获得性、可及性、可负担性、适应性）研究了PWH进行器官移植的障碍。
尽管PWH移植后的结果与普通人群相当，但他们接受器官移植的可能性较小。《HIV器官政策与公平性（HOPE）法案》通过允许将感染HIV的捐赠者的器官移植给感染HIV的接受者，扩大了捐赠者群体。然而，限制扩大的因素包括政策、后勤限制以及与HIV相关的耻辱感。尽管HIV器官移植取得了关键进展，但多层次的挑战仍然限制了PWH获得移植的机会。解决这些障碍对于确保公平获得这种挽救生命的治疗至关重要。
