HIV infection and renal transplantation.
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.
Mazuecos
Auxiliadora
A
Department of Nephrology, Hospital Puerta del Mar, Cadiz, Spain. mauxiliadora.mazuecos.sspa@juntadeandalucia.es
Fernandez
Ana
A
Andres
Amado
A
Gomez
Ernesto
E
Zarraga
Sofia
S
Burgos
Dolores
D
Jimenez
Carlos
C
Paul
Javier
J
Rodriguez-Benot
Alberto
A
Fernandez
Constantino
C
D019380:Anti-HIV Agents / Q000009:adverse effects; D016022:Case-Control Studies; D005260:Female; D006085:Graft Survival; D006678:HIV / Q000472:pathogenicity*; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D019562:Viral Load
D019380:Anti-HIV Agents; D007166:Immunosuppressive Agents