Living with AIDS; Activists Fight Barriers to Organ Transplants for HIV-Positive Patients

A headline announcing the death of writer and AIDS activist Larry Kramer last week was sad news to many -- but no shock, since the 66-year-old's liver had been on the brink of failure for months. So the fact that the news service was wrong, and Kramer was actually doing well after a hard-won liver transplant, was even more joyous news to his friends -- and to others with HIV infections who might eventually need a new liver, kidney or other organ.

If Kramer, by far the most high-profile person with HIV to undergo a transplant, continues to thrive with his new liver, he'll be a very visible boost to efforts to persuade more hospitals to allow organ transplants for people with HIV. Kramer, one of the world's original AIDS activists as founder of New York's Gay Men's Health Crisis, is at the cutting edge again with his transplant, performed Dec. 21 at the University of Pittsburgh Medical Center. He was only the 10th patient with HIV to get a new liver at the hospital's huge transplant center since new drug treatments for the virus vastly extended lives. Within five days, Kramer was out of intensive care and walking. By Friday he was being prepped for release, perhaps as early as this week.

People who once would have swiftly succumbed to AIDS now are living long enough that accompanying diseases -- in Kramer's case, hepatitis B -- can progress to the point of destroying their organs. So the need for transplants among people with HIV is rising, according to Dr. Michelle Roland at the University of California at San Francisco. She is co-leader of a national study of transplants in HIV-infected patients that will provide the first rigorous analysis of outcomes. As an HIV doctor, she hopes it will give the kind of information about survival and drug interactions that doctors say they need to start providing infected patients with transplants.

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