FOR IMMEDIATE RELEASE

July 18, 2001

GLAD Files Suit for HIV-Positive Woman Denied Liver Transplant

(Boston, MA)  Gay & Lesbian Advocates & Defenders (GLAD), working with AIDS Action Committee, filed an emergency lawsuit in federal court on July 16, 20001 against an HMO which denied a life-saving liver transplant for Belynda Dunn, an AIDS Activist who has both HIV and Hepatitis C Virus (HCV) and suffers from end-stage liver disease. Without the transplant, which was to be a living donation from her brother, Ms. Dunn’s doctors said that she had only months to live.

Like many people living with HIV today, Ms. Dunn’s HIV is stable and has not resulted in any illness. Ms. Dunn’s HCV, however, which she contracted when she received a blood transfusion 30 years ago, has resulted in severe liver disease. With only ten percent of liver function and no other medical treatment options, Ms. Dunn’s doctors at Beth Israel Deaconess Hospital recommended a liver transplant as the only means to save her life.  Ms. Dunn’s HMO, Neighborhood Health Plan, refused to approve a medical referral for the transplant, claiming that not enough liver transplants have been done in patients with HIV. For that reason, the HMO characterized a liver transplant for Ms. Dunn as “experimental” and said it was not obligated to cover the procedure.

According to expert medical affidavits filed in the case for Ms. Dunn, a liver transplant is the standard of care, and the only life-saving option, for a person in Ms. Dunn’s condition. HCV is the number one indicator for liver transplants in the nation. Ms. Dunn’s physician, Nezam Afdhal, Director of the Liver Center at Beth Israel Deaconess Hospital, testified that the survival rate of patients with HIV and HCV receiving liver transplants is comparable to that of non-HIV-positive persons with HCV receiving liver transplants.

“The HMO’s actions here were a categorical, absolute denial of liver transplant services for any person who also has HIV,” said GLAD attorney Bennett Klein, who represented Ms. Dunn in the lawsuit. “The HMOs are basically saying that people with HIV do not deserve to have their HCV cured. That is an outrage when a liver transplant will prevent certain death.” Added Klein, “The HMO here claimed that liver transplants for people with HIV are ‘experimental’ solely on the basis that such procedures have only been done in recent years. That does not make a procedure “experimental” under the law. There is no question that HIV itself is not a contraindication for a liver transplant. The reason that liver transplants in HIV-positive patients have only recently been started is that we know that people with HIV can live long lives today so that it makes sense to prevent death from HCV infection. Moreover, we now have more effective antiviral medications to keep HIV in check, which is a prerequisite for liver transplantation.”

While the lawsuit was pending, the defendant, Neighborhood Health Plan, agreed to contribute $100,000 to a fund to pay for liver transplants for people with HIV and HCV. With another $50,000 contributed by Harvard Pilgrim Health Care and several anonymous donations arranged by Mayor Thomas Menino, the fund now totals $275,000.

Belynda Dunn is now able to receive her life-saving liver transplant.  According to GLAD attorney Bennett Klein, “We are thrilled that Belynda is going to get the basic medical care which she deserves. While Belynda’s federal lawsuit will not be going forward because her individual situation has been addressed, GLAD will be pursuing future cases to ensure that HMOs cannot categorically exclude people with HIV from liver transplants.”