A virally-suppressed person living with HIV who receives a donated liver does not experience any increase in their latent HIV reservoir, regardless of the donor’s HIV status or level of viral suppression, according to a U.S.-based study.

About This Study

HIV-Positive Liver Transplant Does Not Alter the Latent Viral Reservoir in Recipients With Antiretroviral Therapy-Suppressed HIV” was published online on June 28, 2023, in The Journal of Infectious Diseases. The lead author is Sarah E. Benner, Ph.D., of the Department of Pathology at Johns Hopkins School of Medicine in Baltimore, Maryland.

Key Research Findings

This small study of virally suppressed people living with HIV (PLWH) who received a liver transplant investigated the effect on the viral reservoir of receiving a donated liver from someone who lived with HIV. As a large lymphoid organ, the liver may provide clues on latent HIV reservoirs that are important in HIV cure research.

For 19 participants, donors were people who had lived with HIV, and for 10 participants, donors had not lived with HIV. Among donors who had HIV, 58% had been on antiretroviral therapy (ART) and 53% had been virally suppressed at the time of their death.

The median age of transplant recipients was 58 years; 83% were men, and 59% were white. Five participants received both a kidney and a liver. All participants were virally suppressed and had received lymphocyte nondepleting therapies to prepare for the transplant.

One year after the transplant, intact and defective provirus levels, as well as CD4 cell counts, remained stable, independent of the donor’s serostatus. The viral suppression status of donors who had HIV at the time of death did not make a difference. Results were similar to those observed in previous studies among PLWH who received a kidney transplant from an HIV-positive donor.

Discussion Highlights and Implications for Practice

Study limitations reported by the researchers included the fact that all recipients were on suppressive ART, there was a lack of data on proviruses in non-circulating CD4 cells, and participants received only lymphocyte nondepleting treatment.

“It is reassuring that the [latent viral reservoir] does not seem to increase with this novel transplantation practice,” study authors concluded.

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