Journal Article

HIV infection and renal transplantation

Auxiliadora Mazuecos, Ana Fernandez, Amado Andres, Ernesto Gomez, Sofia Zarraga, Dolores Burgos, Carlos Jimenez, Javier Paul, Alberto Rodriguez-Benot and Constantino Fernandez

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 26, issue 4, pages 1401-1407
Published in print April 2011 | ISSN: 0931-0509
Published online September 2010 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/gfq592
HIV infection and renal transplantation

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Background. Some aspects of kidney transplant outcome in human immunodeficiency virus (HIV)-infected patients are still controversial. Besides, published experience is scarce in Europe.

Methods. A multicentre case–control study was designed to analyse the outcome of renal transplant in HIV + patients in Spain. Twenty HIV + patients were compared with a matched cohort of 40 HIV − recipients.

Results. Post-transplant follow-up period was 39.98 ± 36.51 months. Pre-transplant dialysis duration and the incidence of pre-transplant opportunistic infections were significantly higher for HIV + patients. Following transplantation, HIV + recipients presented lower incidence of immediate renal function and more acute rejection. Graft survival was lower although the difference was not significant (1 year: 85 vs 97.5%; 5 years: 74.4 vs 91%; log-rank P = 0.058). There was no difference in patient survival rates. Eight patients in each group presented hepatitis C (HCV) infection. Coinfected patients were compared with HIV +/HCV − and HIV −/HCV + recipients. Coinfected patients presented more time on dialysis, greater duration of delayed graft function and lower graft survival (HIV +/HCV + vs HIV +/HCV −: log-rank P = 0.009; HIV +/HCV + vs HIV −/HCV +: log-rank P = 0.02). Conversely, when excluding HCV + patients in both groups, graft survival in HIV + and HIV − patients was similar.

Conclusions. The outcome was good, particularly in non-coinfected patients. Coinfected patients constitute an especially high-risk group for kidney transplantation.

Keywords: hepatitis C; HIV; kidney transplantation

Journal Article.  3647 words.  Illustrated.

Subjects: Nephrology

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