title: Renal transplantation in human immunodeficiency virus-infected recipients: a case-control study from the Brazilian experience.
abstract: BACKGROUND
  Highly active antiretroviral therapy has turned human immunodeficiency virus (HIV)-infected patients with end-stage renal disease into suitable candidates for renal transplantation. We present the Brazilian experience with kidney transplantation in HIV-infected recipients observed in a multicenter study.
  
  
  METHODS
  HIV-infected kidney transplant recipients and matched controls were evaluated for the incidence of delayed graft function (DGF), acute rejection (AR), infections, graft function, and survival of patients and renal grafts.
  
  
  RESULTS
  Fifty-three HIV-infected recipients and 106 controls were enrolled. Baseline characteristics were similar, but a higher frequency of pre-transplant positivity for hepatitis C virus and cytomegalovirus infections was found in the HIV group. Immunosuppressive regimens did not differ, but a trend was observed toward lower use of anti-thymocyte globulin in the group of HIV-infected recipients (P = 0.079). The HIV-positive recipient group presented a higher incidence of treated AR (P = 0.036) and DGF (P = 0.044). Chronic Kidney Disease Epidemiology Collaboration estimated that glomerular filtration rate was similar at 6 months (P = 0.374) and at 12 months (P = 0.957). The median number of infections per patient was higher in the HIV-infected group (P = 0.018). The 1-year patient survival (P < 0.001) and graft survival (P = 0.004) were lower, but acceptable, in the group of HIV-infected patients.
  
  
  CONCLUSIONS
  In the Brazilian experience, despite somewhat inferior outcomes, kidney transplantation is an adequate therapy for selected HIV-infected recipients.
authors: Renal Transplant Unit, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
authors: A R
authors: AR
authors: Vicari
authors: Renal Transplant Unit, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
authors: F
authors: F
authors: Spuldaro
authors: Hospital do Rim, Federal University of São Paulo, São Paulo, SP, Brazil.
authors: T V
authors: TV
authors: Sandes-Freitas
authors: Hospital do Rim, Federal University of São Paulo, São Paulo, SP, Brazil.
authors: M P
authors: MP
authors: Cristelli
authors: Renal Transplant Unit, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors: L R
authors: LR
authors: Requião-Moura
authors: Renal Transplant Unit, Hospital das Clínicas de São Paulo, University of São Paulo, São Paulo, SP, Brazil.
authors: J O
authors: JO
authors: Reusing
authors: Renal Transplant Unit, Hospital das Clínicas de São Paulo, University of São Paulo, São Paulo, SP, Brazil.
authors: L C
authors: LC
authors: Pierrotti
authors: Renal Transplant Unit, Hospital Geral de Fortaleza, Fortaleza, CE, Brazil.
authors: M L
authors: ML
authors: Oliveira
authors: Renal Transplant Unit, Hospital Geral de Fortaleza, Fortaleza, CE, Brazil.
authors: C M
authors: CM
authors: Girão
authors: Renal Transplant Unit, Hospital São Lucas, Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
authors: G
authors: G
authors: Gadonski
authors: Renal Transplant Unit, Hospital São Lucas, Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
authors: L V
authors: LV
authors: Kroth
authors: Hospital Municipal São José e Fundação Pró-Rim, Joinville, SC, Brazil.
authors: L M
authors: LM
authors: Deboni
authors: Hospital Santa Casa de Misericórdia de Juiz de Fora, Juiz de Fora, MG, Brazil.
authors: G F
authors: GF
authors: Ferreira
authors: Hospital do Rim, Federal University of São Paulo, São Paulo, SP, Brazil.
authors: H
authors: H
authors: Tedesco-Silva
authors: Renal Transplant Unit, Hospital Geral de Fortaleza, Fortaleza, CE, Brazil.
authors: R
authors: R
authors: Esmeraldo
authors: Renal Transplant Unit, Hospital das Clínicas de São Paulo, University of São Paulo, São Paulo, SP, Brazil.
authors: E
authors: E
authors: David-Neto
authors: Renal Transplant Unit, Hospital São Lucas, Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
authors: D
authors: D
authors: Saitovitch
authors: Renal Transplant Unit, Hospital Santa Casa de Porto Alegre, Federal University of Medical Sciences of Porto Alegre, Porto Alegre, RS, Brazil.
authors: E
authors: E
authors: Keitel
authors: Renal Transplant Unit, Hospital Santa Casa de Porto Alegre, Federal University of Medical Sciences of Porto Alegre, Porto Alegre, RS, Brazil.
authors: V D
authors: VD
authors: Garcia
authors: Renal Transplant Unit, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors: A
authors: A
authors: Pacheco-Silva
authors: Hospital do Rim, Federal University of São Paulo, São Paulo, SP, Brazil.
authors: J O
authors: JO
authors: Medina-Pestana
authors: Renal Transplant Unit, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil. rmanfro@hcpa.edu.br.
authors: R C
authors: RC
authors: Manfro
mesh_terms: D000328:Adult; D000961:Antilymphocyte Serum / Q000008:administration & dosage; D023241:Antiretroviral Therapy, Highly Active; D001938:Brazil / Q000453:epidemiology; D016022:Case-Control Studies; D060085:Coinfection / Q000453:epidemiology; D003587:Cytomegalovirus / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000453:epidemiology; D005260:Female; D005919:Glomerular Filtration Rate; D006084:Graft Rejection / Q000453:epidemiology*; D006085:Graft Survival; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000401:mortality; D016174:Hepacivirus / Q000302:isolation & purification; D006526:Hepatitis C / Q000453:epidemiology; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods*; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D016030:Kidney Transplantation / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate; D066027:Transplant Recipients; D016896:Treatment Outcome
chemical_list: D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents
keywords: graft rejection; graft survival; human immunodeficiency virus; kidney transplantation; survival analysis