Ethical and Scientific Issues Surrounding Solid Organ Transplantation in Hiv-Positive Patients: Absence of Evidence Is Not Evidence of Absence
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,...
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| Format: | Article |
| Language: | English |
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Wiley
2006-01-01
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| Series: | Canadian Journal of Infectious Diseases and Medical Microbiology |
| Online Access: | http://dx.doi.org/10.1155/2006/286301 |
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| _version_ | 1850229768095531008 |
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| author | Timothy Christie Bashir Jiwani Getnet Asrat Valentina Montessori Richard Mathias Julio Montaner |
| author_facet | Timothy Christie Bashir Jiwani Getnet Asrat Valentina Montessori Richard Mathias Julio Montaner |
| author_sort | Timothy Christie |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-2247f1f43bc44d07a7a35d52beb5e7b9 |
| institution | OA Journals |
| issn | 1712-9532 |
| language | English |
| publishDate | 2006-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Canadian Journal of Infectious Diseases and Medical Microbiology |
| spelling | doaj-art-2247f1f43bc44d07a7a35d52beb5e7b92025-08-20T02:04:06ZengWileyCanadian Journal of Infectious Diseases and Medical Microbiology1712-95322006-01-01171151810.1155/2006/286301Ethical and Scientific Issues Surrounding Solid Organ Transplantation in Hiv-Positive Patients: Absence of Evidence Is Not Evidence of AbsenceTimothy Christie0Bashir Jiwani1Getnet Asrat2Valentina Montessori3Richard Mathias4Julio Montaner5British Columbia Centre for Excellence in HIV/AIDS, CanadaUniversity of Alberta, Edmonton, Alberta, CanadaBritish Columbia Centre for Excellence in HIV/AIDS, CanadaBritish Columbia Centre for Excellence in HIV/AIDS, CanadaUniversity of British Columbia, CanadaBritish Columbia Centre for Excellence in HIV/AIDS, CanadaEnd-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.http://dx.doi.org/10.1155/2006/286301 |
| spellingShingle | Timothy Christie Bashir Jiwani Getnet Asrat Valentina Montessori Richard Mathias Julio Montaner Ethical and Scientific Issues Surrounding Solid Organ Transplantation in Hiv-Positive Patients: Absence of Evidence Is Not Evidence of Absence Canadian Journal of Infectious Diseases and Medical Microbiology |
| title | Ethical and Scientific Issues Surrounding Solid Organ Transplantation in Hiv-Positive Patients: Absence of Evidence Is Not Evidence of Absence |
| title_full | Ethical and Scientific Issues Surrounding Solid Organ Transplantation in Hiv-Positive Patients: Absence of Evidence Is Not Evidence of Absence |
| title_fullStr | Ethical and Scientific Issues Surrounding Solid Organ Transplantation in Hiv-Positive Patients: Absence of Evidence Is Not Evidence of Absence |
| title_full_unstemmed | Ethical and Scientific Issues Surrounding Solid Organ Transplantation in Hiv-Positive Patients: Absence of Evidence Is Not Evidence of Absence |
| title_short | Ethical and Scientific Issues Surrounding Solid Organ Transplantation in Hiv-Positive Patients: Absence of Evidence Is Not Evidence of Absence |
| title_sort | ethical and scientific issues surrounding solid organ transplantation in hiv positive patients absence of evidence is not evidence of absence |
| url | http://dx.doi.org/10.1155/2006/286301 |
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