Abstract
<h3>Purpose</h3> The impact of HIV infection on outcomes after left ventricular assist device (LVAD) implantation is unknown. The purpose of this analysis was to assess the impact of HIV infection on post LVAD survival using STS Intermacs data. <h3>Methods</h3> NIH BioLINCC Intermacs data were utilized for this analysis (implants between June 2005- Dec 2017). Patients with missing HIV data or coded as total artificial heart were excluded. Survival to 2 years between first time LVAD recipients with and without HIV infection was assessed using Kaplan-Meier curves and multivariable Cox regression, adjusting for age, body mass index, race, marital status, drug use, ischemic cardiomyopathy, destination therapy (DT), and INTERMACS status. Patients were censored at time of transplant, or recovery. Occurrence of adverse events by 6 months were also compared. <h3>Results</h3> A total of 15,465 patients were included in this analysis (HIV infection: 49, Non-HIV: 15,416) The median follow up time was 12.8 months. Patients with HIV infection were younger and were more likely to be black, destination therapy, and single. Ninety percent of patients with HIV infection were on any anti-retroviral therapy with a median CD4 count of 554 cell/mm<sup>3</sup> [IQR: 345, 924]. HIV infection was associated with increased mortality on LVAD support, which reached statistical significance in the adjusted models (unadjusted HR: 1.55, 95% CI; 0.93-2.57, p=0.09, adjusted HR: 1.82, 95% CI; 1.09 -3.04, p 0.020, <b>Figure</b>). Among those with and without HIV infection, there were no statistically significant differences in adverse events (infection, stroke, device malfunction, bleeding) by 6 months post implant. <h3>Conclusion</h3> In this small sample of LVAD patients with HIV infection, survival was lower compared to those without HIV infection. Further data are needed to confirm these findings and determine potential mechanisms of increased mortality.
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