title: Renal Transplantation in HIV-positive Renal Transplant Recipients: Experience at the Mannheim University Hospital.
abstract: Renal transplantation in HIV-positive patients with end-stage renal disease has in recent years become a successful treatment option. We report two patients who underwent renal transplantation using a combination of basiliximab, calcineurin inhibitors, mycophenolate mofetil (MMF), and steroids with a "non-interacting" antiretroviral combination therapy consisting of stavudine or abacavir, lamivudine, and nevirapine. We observed no acute rejection but a BK polyomavirus infection in both patients. In conclusion, a quadruple immunosuppression with an interleukin 2 receptor antagonist, a calcineurin inhibitor, MMF, and steroids appears to be advisable to prevent high rates of acute rejection, but if possible thereafter immunosuppression should be tapered rapidly (eg, MMF stop, prednisolone dose 5 mg/d). The selection of antiretroviral agents should avoid compounds that interact severely with the immunosuppression used.
authors.affiliation: Fifth Department of Medicine & Renal Transplant Program, University Medicine Mannheim, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Haas
authors.affiliation: Fifth Department of Medicine & Renal Transplant Program, University Medicine Mannheim, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Singer
authors.affiliation: Department of Surgery & Renal Transplant Program, University Medicine Mannheim, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Nowak
authors.affiliation: HIV & Hematology/Oncology Specialist Practice, Mannheim, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Brust
authors.affiliation: Fifth Department of Medicine & Renal Transplant Program, University Medicine Mannheim, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Göttmann
authors.affiliation: Fifth Department of Medicine & Renal Transplant Program, University Medicine Mannheim, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Schnülle
authors.affiliation: Fifth Department of Medicine & Renal Transplant Program, University Medicine Mannheim, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Krüger
authors.affiliation: Fifth Department of Medicine & Renal Transplant Program, University Medicine Mannheim, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany.
authors.forename: B K
authors.initials: BK
authors.lastname: Krämer
authors.affiliation: Fifth Department of Medicine & Renal Transplant Program, University Medicine Mannheim, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany. Electronic address: urs.benck@umm.de.
authors.forename: U
authors.initials: U
authors.lastname: Benck
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D000077552:Basiliximab; D065095:Calcineurin Inhibitors / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control*; D015658:HIV Infections / Q000188:drug therapy*; D006785:Hospitals, University; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007668:Kidney / Q000187:drug effects / Q000821:virology; D007676:Kidney Failure, Chronic / Q000601:surgery* / Q000821:virology; D016030:Kidney Transplantation; D008297:Male; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D011239:Prednisolone / Q000627:therapeutic use; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use; D013256:Steroids / Q000627:therapeutic use
chemical_list: D000911:Antibodies, Monoclonal; D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents; D011993:Recombinant Fusion Proteins; D013256:Steroids; D000077552:Basiliximab; D011239:Prednisolone; D009173:Mycophenolic Acid