Improving the outcomes of human immunodeficiency virus/hepatitis C virus–coinfected transplant recipients: The answer is Blowin’ in the wind

Hepatitis C (HCV) infection is the leading cause of liver disease in hemophilia. In those with HIV/HCV co-infection, the rate of liver disease progression is greater than in HCV mono-infected individuals. Despite antiretroviral therapy which slows HCV liver disease progression, some require transplantation. Whether transplant outcomes are worse in hemophilic (H) than non-hemophilic (NH) candidates is unknown. In order to determine rates and predictors of pre- and post-transplant survival, we conducted a retrospective observational study utilizing United Network for Organ Sharing (UNOS) national transplant registry data, comparing HCV+ H and NH candidates. We identified 2,502 HCV+ liver transplant candidates from eight U.S. university-based transplant centers, between January 1, 2004 to December 31, 2010, including 144 HIV+ (6%) and 2,358 HIV−; 36 H (1%) and 2,466 NH; 1,213 (48%) transplanted and 1,289 not transplanted. Other than male predominance and younger age, each p