Solid-organ transplantation in HIV-infected patients in the potent antiretroviral therapy era.
Improvements in antiretroviral therapy, opportunistic infection prophylaxis, and antirejection treatment have made solid-organ transplantation a potential option for HIV-infected patients. Preliminary experience in a small group of kidney and liver transplant recipients suggests that CD4+ cell counts and plasma HIV RNA level suppression can be maintained. As few opportunistic infections have been seen, as history of some opportunistic infection conditions may not be a contraindication to transplantation; this question is under investigation. Kidney graft rejection rates graft-survival rates appear to be similar to those in HIV-uninfected populations. A large multicenter study of the safety and efficacy of kidney and liver transplantation in HIV-infected patients is under way. Findings from this study should help to provide guidance in achieving optimal outcomes in this population. This article summarizes a presentation by Michelle E. Roland, MD, at the February and April 2004 International AIDS Society-USA courses in Atlanta, Los Angeles, and Chicago.
Roland
Michelle E
ME
University of California Positive Health Program (HIV/AIDS Division), San Francisco General Hospital, San Francisco, CA, USA.
D023241:Antiretroviral Therapy, Highly Active / Q000379:methods*; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology / Q000401:mortality; D006801:Humans; D016867:Immunocompromised Host; D016030:Kidney Transplantation / Q000276:immunology* / Q000379:methods; D016031:Liver Transplantation / Q000276:immunology* / Q000379:methods; D008297:Male; D011379:Prognosis; D018570:Risk Assessment; D016019:Survival Analysis; D014181:Transplantation Immunology / Q000502:physiology; D016896:Treatment Outcome