The optimal timing of listing and transplantation of the HCV/HIV patient remains a challenge, and waiting list mortality appears higher than in HIV-negative patients [12]. Poor outcome might reflect late referral for transplant assessment and/or more rapid deterioration after the onset of hepatic decompensation. In either case, it is imperative that HIV-positive patients Galunisertib chemical structure with a diagnosis of ESLD are co-managed by an experienced HIV physician and a hepatologist with close links to a transplant unit, thus permitting expeditious referral and assessment at the first sign of decompensation. 1 

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