Cardiovascular risk and liver transplantation in HIV patients. Are HIV infected liver transplant recipients at higher risk

Abstract Background Cardiovascular (CV) diseases are currently one of the main causes of morbimortality in HIV-infected patients. Similarly, LT recipients have increased prevalence of CV risk factors. Our aim was to assess whether HIV infected LT patients have an increased prevalence of CV risk factors and events (CVE) as compared to non-HIV LT patients. Methods We included LT recipients from 2004-2016 from a single center. HIV-infected patients were matched to 2 non-HIV controls each by sex, liver disease etiology, and date of LT. Results A total of 138 LT recipients were included (46 HIV-infected and 92 HIV-uninfected). HCV was the main etiology (85% of HIV-infected and 83% of HIV-uninfected), followed by alcohol. Mean follow-up was 5.5 years in the HIV vs 6.1 years in the non-HIV group. Most patients (85%)in both groups were men. HIV-infected group was younger at LT (47 vs 51 years, p 0.0137). Prevalence of CV risk factors was similar in both groups. BMI was significantly lower in HIV-infected patients (24.3vs 27.1,p 0.0004). Incidence of CV risk factors post-LT was increased as compared to the pre-LT setting in both groups. HIV patients showed a trend towards an increased cumulative incidence of CVE post-LT, as compared to non-HIV patients (HR 1.2, pNS). Conclusion In the post-LT setting, HIV and non-HIV patients present similar prevalence of CV risk factors, but HIV patients present a trend towards an increased cumulative incidence of CV events. An intensive management of CV risk factors in the post-LT period is mandatory.