title: Association Between Duration of Human Immunodeficiency Virus (HIV)-1 Viral Suppression Prior to Renal Transplantation and Acute Cellular Rejection.
abstract: Renal transplant has become an important option for human immunodeficiency virus (HIV)-infected patients with end-stage renal disease; however, these patients experience a high rate of acute cellular rejection (ACR). Guidelines do not currently exist for the optimal duration of viral suppression prior to transplantation. In a retrospective cohort analysis of 47 HIV-infected renal transplant recipients, we compared the rate of ACR between patients based on the length of time of viral suppression prior to transplantation. Of the patients who achieved viral suppression for >6 months but less than 2 years prior to transplantation (n = 15), 60% experienced ACR compared to 41% of patients suppressed at least 2 years or more (n = 32) prior to transplant (p = 0.21). Patients suppressed <2 years experienced ACR at 2.48 times the rate of those suppressed 2 years or longer. Induction immunosuppression, HLA mismatch and panel-reactive antibodies (PRAs) did not significantly differ between the two groups.
authors.affiliation: The Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD.
authors.forename: J
authors.initials: J
authors.lastname: Husson
authors.affiliation: The Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD.|Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD.
authors.forename: K
authors.initials: K
authors.lastname: Stafford
authors.affiliation: Division of Transplant Surgery, University of Maryland School of Medicine, Baltimore, MD.
authors.forename: J
authors.initials: J
authors.lastname: Bromberg
authors.affiliation: Division of Nephrology, University of Maryland School of Medicine, Baltimore, MD.
authors.forename: A
authors.initials: A
authors.lastname: Haririan
authors.affiliation: University of Maryland School of Pharmacy, Baltimore, MD.
authors.forename: T
authors.initials: T
authors.lastname: Sparkes
authors.affiliation: The Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD.
authors.forename: C
authors.initials: C
authors.lastname: Davis
authors.affiliation: The Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD.
authors.forename: R
authors.initials: R
authors.lastname: Redfield
authors.affiliation: The Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD.
authors.forename: A
authors.initials: A
authors.lastname: Amoroso
mesh_terms: D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000175:diagnosis / Q000209:etiology*; D006085:Graft Survival; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000821:virology; D015497:HIV-1 / Q000472:pathogenicity*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D019380:Anti-HIV Agents
keywords: clinical research/practice; editorial/personal viewpoint; infection and infectious agents; infectious disease; kidney (allograft) function/dysfunction; kidney transplantation/nephrology; viral: human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS)