HIV-positive
woman appeals decision to deny transplant

Lambda Legal is appealing a decision by Arizona's Medicaid program denying a woman a liver transplant because she has HIV, saying the refusal may cost the woman her life. "Essentially [the Medicaid provider] has a list of conditions that disqualify people for transplants, and HIV is on that list as a blanket rejection. There is no valid scientific evidence that indicates that people who have HIV fare any worse than anyone else who needs an organ transplant," said Jen Sinton, HIV project staff attorney at Lambda.

In their appeal, filed Thursday in preparation for Friday's hearing, Lambda specifically cites a 2002 New England Journal of Medicine article on the subject finding "no evidence of poorer survival among otherwise healthy HIV-positive patients who are receiving antiretroviral therapy," which Sinton said is this patient's case. "We firmly believe the policy is unlawful, and we ask the Arizona Medicaid program to grant an exception," Sinton said. "We would also like to change the Arizona Medicaid policy and take HIV off the blanket list."

The patient, 49-year-old Phoenix resident Brenda Gwin, was diagnosed with end-stage liver disease in November 2004, and her condition deteriorated soon after. In June 2005 her doctors said she qualified for a liver transplant, but the Arizona Health Care Cost Containment System--the state's Medicaid program--denied the request for coverage. "Without the transplant her treating physician has estimated that her life expectancy would be no more than five years and very possibly less than one year," Sinton said.

According to Lambda, HIV-positive patients being singled out for denied coverage is not new. "I think some of these policies originated in the very early years of AIDS in the U.S. when there were not viable treatment options," said Sinton. "There shouldn't be any blanket rule for HIV; you really need to look at individual cases." On Thursday, California governor Arnold Schwarzenegger signed a bill saying medical providers can't deny organ transplantation based on HIV status alone. (Neal Broverman/Advocate.com)