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2020, Number 2

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Enf Infec Microbiol 2020; 40 (2)

CD4 lymphocyte values in a patient with HIV during the first year after kidney transplantation

Martínez-Ulloa TJ, Torres ED, Baas CJP, Gamboa GR, Domínguez BT, Aguilar TF, Gutiérrez TP

Language: Spanish
References: 18
Page: 64-67
PDF size: 313.69 Kb.


ABSTRACT

There is an important relationship between human immunodeficiency virus (HIV) and the development of end-stage kidney disease. For a long time, seropositivity was considered a contraindication for transplantation. Access to transplantation in HIV patients has been allowed thanks to highly active antiretroviral treatment (TARAA) and better compression of immunosuppression. This is the report of the third case made within the Mexican Institute of Social Security in Mexico.
Clinical case. A 31-year-old male HIV infected without comorbidities and with criteria for a related living donor kidney transplant. He received immunosuppression of induction with basiliximab and maintenance with calcineurin inhibitor, antimetabolite and steroids. A change in haart therapy before and after surgery is described, as well as behavior of CD4 lymphocytes and viral load during a fifhten-month follow-up. He has no events of acute rejection or opportunistic infections, with good post-transplant kidney function.
Conclusion. Kidney transplantation may be a safe and viable option for a sector of patients infected with HIV, associated with a significant survival benefit compared to remaining on dialysis.


REFERENCES

  1. Wyatt, Christina M., “Kidney disease and vih infection”, Top Antivir Med, 2017, 25 (1): 13-16.

  2. Swanepoel, C.R. et al., “Kidney disease in the setting of hiv infection: conclusions from a kidney disease: improving global outcomes (kdigo) controversies conference”, Kidney Int, 2018, 93 (3): 545-559.

  3. Szckech, L., “Renal asociated with human inmunodeficiency virus infections: epidemiology, clinical course and managements”, Clin Infect Dis, 2001, 33: 115-119.

  4. Abecassis, Michael et al., “Kidney transplantation as primary therapy for end-stage renal disease: a National Kidney Foundation/Kidney Disease Outcomes Quality Initiative (nkf/kdoqi™) Conference”, Clin J Am Soc Nephrol, 2008, 3 (2): 471-480.

  5. Spital. A, et al., “Should all human immunodeficiency virus-infected patients with end-stage renal disease be excluded from transplantation? The views of U.S. transplant centers”, Transplantation, 1998, 65 (9): 1187.

  6. Gulick, R.M. et al., “Treatment with indinavir, zidovudine, and lamivudine in adults with human immunodeficiency virus infection and prior antiretroviral therapy”, N Engl J Med, 1997, 337 (11): 734.

  7. Locke, J.E. et al., “Survival benefit of kidney transplantation in hiv-infected patients”, Ann Surg, 2017, 265 (3): 604-608.

  8. Bhagani, S. et al., “Guidelines for kidney transplantation in patients with hiv disease”, hiv Med, 2006, 7: 133-139.

  9. Suárez, J.F. et al., “Pre-transplant cd4 count influences immune reconstitution and risk of infectious complications in human immunodeficiency virus-infected kidney allograft recipients”, Am J Transplant, 2016, 16: 2463-2472.

  10. Rodrigo, E. et al., “Heterogeneity of induction therapy in Spain: changing patterns according to year, centre, indications and results”, ndt Plus, 2010, 3 (Suppl_2): ii9.

  11. Carter, J.T. et al., “Thymoglobulin-associated cd4+ t-cell depletion and infection risk in hiv-infected renal transplant recipients”, Am J Transplant, 2006, 6 (4): 753-760.

  12. Rollins, Brett et al., “Higher rates of rejection in hiv-infected kidney transplant recipients on ritonavir-boosted protease inhibitors-three-year follow up”, Transplantation, 2018, 102: S91.

  13. M.E., Barin, B., Carlson, L. et al., “hiv-infected liver and kidney transplant recipients: 1 and 3-year outcomes”, Am J Transplant, 2008, 8: 355-365.

  14. Deeks, Steven G. et al., “Systemic effects of inflammation on health during chronic hiv infection”, Immunity, 2013, 39 (4): 633-645.

  15. Sawinski, Deirdre et al., “Kidney transplantation in hivinfected individuals”, UpToDate, 2019.

  16. Izzedine, H. et al., “Antiretroviral and immunosuppressive drug-drug interactions: an update”, Kidney Int, 2004, 66: 532-541.

  17. Hossain, M.M. et al., “Dose proportional inhibition of hiv-1 replication by mycophenolic acid and synergistic inhibition in combination with abacavir, didanosine, and tenofovir”, Antiviral Res, 2002, 55: 41-52.

  18. Chapuis, A.G. et al., “Effects of mycophenolic acid on human immunodeficiency virus infection in vitro and in vivo”, Nat Med, 2000, 6: 762-768.




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