Kidney transplantation in HIV-positive adults: the UK experience.

TitleKidney transplantation in HIV-positive adults: the UK experience.
Publication TypeJournal Article
Year of Publication2014
AuthorsGathogo EN, Hamzah L, Hilton R, Marshall N, Ashley C, Harber M, Levy JB, Jones R, Boffito M, Khoo SH, Drage M, Bhagani S, Post FA
Corporate AuthorsUK HIV/Kidney Transplantation Study Group(see appendix)
JournalInternational journal of STD & AIDS
Volume25
Issue1
Pagination57-66
Date Published2014 Jan
Abstract

HIV-positive patients are at increased risk of end-stage kidney disease (ESKD). Kidney transplantation (KT) is an established treatment modality for ESKD in the general population. Recent data have confirmed the feasibility of kidney transplantation in HIV-positive patients, and kidney transplantation is increasingly offered to ESKD patients with well-controlled HIV infection. We report clinical outcomes in a national cohort study of kidney transplantation in HIV-positive patients. In all, 35 HIV-positive KT recipients who had undergone KT up to December 2010 (66% male, 74% black ethnicity) were identified; the median CD4 cell count was 366, all had undetectable HIV RNA levels at kidney transplantation, and 44% received a kidney from a live donor. Patient survival at 1 and 3 years was 91.3%, and graft survival 91.3% and 84.7%, respectively. At one-year post-kidney transplantation, the cumulative incidence of acute rejection was 48%, and the median (IQR) eGFR was 64 (46, 78) mL/min/1.73 m(2). Although HIV viraemia and HIV disease progression were uncommon, renal complications were relatively frequent. Our study corroborates the feasibility of kidney transplantation in HIV-positive patients. The high rates of acute rejection suggest that the optimal immune suppression strategy in this population remains to be refined.

DOI10.1371/journal.pone.0074157
Alternate JournalInt J STD AIDS