*Purpose: Several studies have reported that HIV+ patients are 4-6 times more likely to develop HCC than uninfected individuals. Our aim was to assess outcomes in HIV+ patients with HCC in the US following Liver Transplantation (LT) using the UNOS dataset.

*Methods: The database was queried from 2003-2016 for patients undergoing LT with HCC (alone), HIV+ (alone transplanted for other indications), and HCC/HIV+. A 3:1 case matching was performed.

*Results: Out of 17,397 LT performed for HCC during the study period, 113 were transplanted for HCC with HIV infection (91 isolated livers). Patients transplanted for HCC/HIV+ were younger (55.54 ± 5.89 vs 58.80 ± 7.37, p<0.001), had lower total bilirubin (1.20 vs 1.60, p=0.042) significantly lower BMI (25.35 ± 4.43 vs 28.39 ± 5.17, p<0.001) and were more likely to be co-infected with HBV (25.3% vs 8.2% p<0.001) than those transplanted for HCC alone. HCC/HIV+ patients were found to have a 3.8 fold increased risk of peri-operative mortality at 90 days after matching. HCC/HIV+ recipients had 54% decreased long-term survival within the HCC cohort. Our initial analysis of overall graft and patient survival found significant differences between HCC/HIV- and HCC/HIV+ recipients. However, these variances were lost after case-matching. Recurrence and disease free survival were similar in HCC alone vs HCC/HIV+ recipients.

*Conclusions: Our analysis suggests that excellent outcomes can be achieved in selected patients with HCC/HIV+. Future studies are warranted to assess the impact of histopathological characteristics on HCC patients with HIV infection following LT.

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