“Raising HOPE”: Improved Outcomes for HIV/HCV-coinfected Liver Transplant Recipients in the Direct-acting Antiviral Era

The 2013 HIV Organ Policy Equity Act has increased liver transplantation (LT) in HIV patients; however, transplant centers may remain reluctant to perform LT in HIV/hepatitis C virus (HCV)-coinfected patients due to inferior outcomes. We aimed to assess how direct-acting antivirals (DAAs) have impacted HIV /HCV -coinfected LT recipient outcomes. national data including 70 125 adult LT recipients between 2008 and 2019 were analyzed. Kaplan-Meier survival analysis and Cox proportional hazards model were used to analyze outcomes. LT for HIV individuals increased in the DAA era from 28 in 2014 to 64 in 2019 (23 had HIV /HCV coinfection). In the pre-DAA era, HIV /HCV -coinfected LT recipients had an increased risk of graft failure compared with HIV /HCV -uninfected LT recipients (hazard ratio [HR], 1.85;