Ethical and Scientific Issues Surrounding Solid Organ Transplantation in HIV-Positive Patients: Absence of Evidence Is Not Evidence of Absence
The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie médicale / AMMI Canada 2006 Jan; 17(1): 15-8
End-stage liver disease is emerging as a leading cause of death among HIV-positive patients. Historically, an HIV diagnosis was a contraindication for a liver transplant; however, because of the efficacy of highly active antiretroviral therapy (HAART), HIV-positive patients have one-year, two-year, and three-year post-transplantation survival rates similar to that of HIV-negative patients. Based on this evidence, HIV-positive patients are now considered eligible for transplantation. However, newly emerging guidelines include the stipulation that HIV-positive patients must be on HAART to be placed on a waiting list for transplantation. The purpose of the present paper is to evaluate the scientific and ethical probity of requiring HIV-positive patients to be on HAART as a condition for being on a liver transplant waiting list. It is argued that the emphasis should be placed on the probability of post-transplantation HAART tolerance, and that concerns about pretransplantation HAART tolerance are of secondary importance.
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Exploring Disparities Between Global HIV/AIDS Funding and Recent Tsunami Relief Efforts: An Ethical Analysis Christie, Timothy; Asrat, Getnet A.; Jiwani, Bashir; Maddix, Thomas; Montaner, Julio S.G. (2007-04)Objective: To contrast relief efforts for the 26 December 2004 tsunami with current global HIV/AIDS relief efforts and analyse possible reasons for the disparity. Methods: Literature review and ethical analysis. Results: ...