Under the HIV Organ Policy Equity (HOPE) Act, livers from donors with HIV can be used for transplants in recipients with HIV (HIV D+/R+). Early studies show that overall outcomes are acceptable and that this practice can decrease waiting times; however, there may be more opportunistic infections and cancers compared to liver transplants from donors without HIV, and long-term outcomes are unknown. In this study, we will quantify any increased risk of opportunistic infection and cancer with HIV D+ livers, 2) measure long term outcomes, and 3) perform scientific studies to understand why infections and cancer develop.