Renal transplantation in HIV-positive patients - No more a scare!

Saudi J Kidney Dis Transpl. 2017 Sep-Oct;28(5):1106-1111. doi: 10.4103/1319-2442.215132.

Abstract

Human immunodeficiency virus (HIV) infection has posed as a major global health epidemic for almost three decades. With the advent of highly active antiretroviral therapy in 1996 and the application of prophylaxis and management of opportunistic infections, acquired immunodeficiency syndrome mortality has decreased markedly. The most aggressive HIV-related renal disease is end-stage renal disease due to HIV-associated nephropathy. Presence of HIV infection used to be viewed as a contraindication to renal transplantation for multiple reasons; concerns for exacerbation of an already immunocompromised state by administration of additional immunosuppressants; the use of a limited supply of donor organs with unknown long-term outcomes. Multiple studies have reported promising outcomes at three to five years after kidney transplantations in patients treated with highly active antiretroviral therapy, and HIV is no longer a contraindication for renal transplant. Hence, we present eight HIV-positive patients who received live-related renal transplantation at our center and their follow-up.

MeSH terms

  • AIDS-Associated Nephropathy / diagnosis
  • AIDS-Associated Nephropathy / immunology
  • AIDS-Associated Nephropathy / surgery*
  • AIDS-Associated Nephropathy / virology
  • Anti-HIV Agents / adverse effects
  • Anti-HIV Agents / therapeutic use*
  • Antiretroviral Therapy, Highly Active
  • Clinical Decision-Making
  • Disease Progression
  • Female
  • Graft Rejection / immunology
  • Graft Rejection / prevention & control
  • Graft Survival / drug effects
  • HIV Infections / diagnosis
  • HIV Infections / drug therapy*
  • HIV Infections / immunology
  • HIV Infections / virology
  • Humans
  • Immunocompromised Host
  • Immunosuppressive Agents / therapeutic use
  • Kidney Failure, Chronic / diagnosis
  • Kidney Failure, Chronic / immunology
  • Kidney Failure, Chronic / surgery*
  • Kidney Failure, Chronic / virology
  • Kidney Transplantation / adverse effects
  • Kidney Transplantation / methods*
  • Living Donors
  • Male
  • Middle Aged
  • Risk Factors
  • Time Factors
  • Treatment Outcome

Substances

  • Anti-HIV Agents
  • Immunosuppressive Agents