Clinical outcome of kidney transplantation in HIV-infected recipients: a retrospective study. (November 2018)

• Record Type: Journal Article
• Authors: Alfano, Gaetano; Mori, Giacomo; Fontana, Francesco; Dolci, Giovanni; Baisi, Alberto; Ligabue, Giulia; Ferrari, Annachiara; Solazzo, Andrea; Franceschini, Erica; Guaradi, Giovanni; Mussini, Cristina; Cappelli, Gianni
• Is Part Of: International journal of STD & AIDS. Volume 29:Number 13(2018)
• Page Start: 1305
• Page End: 1315
• Publication Date: 2018-11
• Subjects: HAART -- transplantation -- Europe -- HIV; Sexually transmitted diseases -- Periodicals; AIDS (Disease) -- Periodicals; 616.951
• DOI: 10.1177/0956462418779659
• Languages: English
• ISSNs: 0956-4624

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 mm 3 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.