Clinical outcome of kidney transplantation in HIV-infected recipients: a retrospective study

Int J STD AIDS. 2018 Nov;29(13):1305-1315. doi: 10.1177/0956462418779659. Epub 2018 Jul 10.

Abstract

Kidney transplantation is a safe and effective option for HIV-positive (HIV+) patients. We conducted a retrospective study on HIV+ kidney transplant recipients who underwent transplantation from March 2008 to September 2016. Inclusion criteria for transplantation were CD4+ T-cell count ≥200 per mm3 and undetectable HIV load. The current study reports the outcome of 19 HIV+ recipients, mostly of Caucasian origin (79%) with a median age of 50 years (interquartile range [IQR], 42-52), who were followed up for a median period of 2.4 years (IQR, 1.2-4.6) after transplantation. Compared with HIV-negative (HIV-) controls, HIV+ recipients had similar one- and three-year graft and patient survival, but significantly lower five-year patient survival (P = 0.03). The differences in graft outcome became less evident with the analysis of death-censored graft survival rates. Cumulative incidence of allograft rejection at one year was 32.9%. Rates of infections were not particularly elevated and HIV replication remained well controlled in all but one patient. A high prevalence of metabolic and endocrine complications (68%) was reported after transplantation. Further studies are needed to evaluate long-term outcomes of HIV+ recipients who underwent kidney transplantation.

Keywords: Europe; HAART; HIV; transplantation.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Adult
  • Antiretroviral Therapy, Highly Active
  • CD4 Lymphocyte Count
  • Female
  • Graft Rejection / epidemiology
  • Graft Survival*
  • HIV Infections / complications*
  • HIV Infections / drug therapy
  • HIV Seronegativity*
  • Humans
  • Incidence
  • Kidney Failure, Chronic / mortality
  • Kidney Failure, Chronic / surgery*
  • Kidney Transplantation / statistics & numerical data*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome
  • Viral Load