Transplantation from donors with HCV-viremia to recipients without HCV-viremia (HCV D+/R-) is common, but no data exist for recipients with HIV or donors with HCV/HIV co-infection. We assessed outcomes of HCV D+/R- transplants within three HIV Organ Policy Equity Act studies of HIV+ abdominal transplantation to recipients with HIV between 2017-2023. Eighteen kidney and 6 liver HIV+ transplant recipients received organs from 19 donors with HCV viremia, including 7 with HCV/HIV co-infection. Median recipient age was 58 years, 96% were male, and median waitlist time was one year. All recipients had undetectable HIV RNA at time of transplant with median CD4 count 499 cells/mm