AIDS sufferers unjustly denied transplants, activists say - Canada

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AIDS sufferers unjustly denied transplants, activists say

Operation 'next to impossible' to get done in Canada, Ottawa doctor asserts

From Wednesday's Globe and Mail

August 6, 2008 at 3:11 AM EDT

MEXICO CITY — People with HIV-AIDS are being unjustly and unnecessarily denied

organ transplants in the face of strong scientific evidence that they do as well

after surgery as patients who are not infected, a coalition of Canadian

activists says.

While there is no rule specifically barring people with HIV-AIDS from getting

transplants, " in practice it's next to impossible to get it done in Canada, "

physician Curtis said at the International AIDS Conference in Mexico

City.

He noted that the large majority of liver transplants are now done on people

suffering from hepatitis C or hepatitis B. Many of them are also infected with

HIV-AIDS because the viruses are all spread in the same way, through blood and

bodily fluids.

" I'm not asking for special access for those who are co-infected, just fairness

in access, " said Dr. , who practises in the Ottawa Hospital's Viral

Hepatitis Clinic.

He said many surgeons believe, incorrectly, that patients with HIV-AIDS are poor

candidates for new organs because transplant recipients must take

immune-suppressing drugs. But studies have shown the drugs do not exacerbate

infections in patients with HIV-AIDS, and countries such as the United States,

Britain, Spain and France have been doing the procedures for a decade or more.

There are an estimated 58,000 Canadians living with HIV-AIDS. Close to one-third

of them are also infected with hepatitis, which can cause liver disease.

Dr. estimates that about 50 patients co-infected with HIV and the

hepatitis C virus require a liver transplant, and a lesser number require kidney

transplants.

, a retired Toronto physician, is one of them. He noted that

advances in the treatment of HIV-AIDS have resulted in the disease being

well-controlled, but the same cannot be said of hepatitis C, which is destroying

his liver.

" What places my health at greatest risk is the lack of a well-functioning

liver, " he said, adding that he has not been able to get on an organ transplant

waiting list.

Louise Binder, chairwoman of the Canadian Treatment Action Council, said

patients like Dr. are being discriminated against because of their HIV

status based on " specious arguments " like a shortage of organs and fears that

surgeons will be infected during surgery.

" It's true that organs for transplant are in short supply but, nonetheless,

those with HIV, hep C or B can be equally good candidates, " she said.

Ms. Binder said that fear of contracting HIV-AIDS is not valid because surgeons

take precautions with all patients, and those with HIV-AIDS who would benefit

from a transplant would almost certainly be taking medications that leave them

with such a low viral load they are virtually non-infectious. Hepatitis viruses

are also far more infectious, and surgeons routinely operate on patients with

hepatitis, she said.