Evaluating the Safety and Outcomes of Kidney Transplants from HIV-Positive Donors to HIV-Positive Recipients
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Reviewed by Dat Tien Nguyen, B.A, ScM.
Translated by Nhi Phuong Quynh Le, B.A |
Posted on November 29th, 2024
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Kidney transplantation is the preferred treatment for patients with end-stage renal disease, while dialysis serves as a temporary solution. However, individuals living with HIV face lower chances of receiving a kidney transplant compared to HIV-negative patients. Furthermore, HIV-positive patients undergoing dialysis are at a higher risk of death. In light of this, the National Institute of Allergy and Infectious Diseases sponsored a study to explore the feasibility of transplanting kidneys from HIV-positive donors into HIV-positive recipients.
The observational study was conducted in the United States with 408 HIV-positive patients diagnosed with end-stage renal disease who were eligible for kidney transplantation. In 35% of the cases, kidney failure was attributed to HIV-associated nephropathy, while diabetes and hypertension were responsible for the remaining cases. The participants had well-controlled HIV, with a median CD4+ cell count of approximately 500 cells/uL, and most had fewer than 200 copies of HIV RNA per mL. The patients were assigned to receive a kidney from either an HIV-positive or an HIV-negative donor. After three years of follow-up, the researchers found no significant difference in the risk of death or graft rejection between those who received a kidney from an HIV-positive versus an HIV-negative donor. However, the risk of breakthrough HIV infection was three times higher in recipients of kidneys from HIV-positive donors, though these infections were manageable with antiretroviral therapy.
The observational study was conducted in the United States with 408 HIV-positive patients diagnosed with end-stage renal disease who were eligible for kidney transplantation. In 35% of the cases, kidney failure was attributed to HIV-associated nephropathy, while diabetes and hypertension were responsible for the remaining cases. The participants had well-controlled HIV, with a median CD4+ cell count of approximately 500 cells/uL, and most had fewer than 200 copies of HIV RNA per mL. The patients were assigned to receive a kidney from either an HIV-positive or an HIV-negative donor. After three years of follow-up, the researchers found no significant difference in the risk of death or graft rejection between those who received a kidney from an HIV-positive versus an HIV-negative donor. However, the risk of breakthrough HIV infection was three times higher in recipients of kidneys from HIV-positive donors, though these infections were manageable with antiretroviral therapy.