2007 JASN IMPACT FACTOR 7.111	HOME   AUTHOR INFO   EDITORIAL BOARD   SUBSCRIBE   FEEDBACK   ALERTS   HELP
advanced	CURRENT ISSUE	ARCHIVES	JASN Express	ONLINE SUBMISSION

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Abbott, K. C. Articles by Kimmel, P. L. Search for Related Content PubMed PubMed Citation Articles by Abbott, K. C. Articles by Kimmel, P. L.

Human Immunodeficiency Virus Infection and Kidney Transplantation in the Era of Highly Active Antiretroviral Therapy and Modern Immunosuppression

Kevin C. Abbott^*, S. John Swanson, Lawrence Y.C. Agodoa and Paul L. Kimmel, MD

*Nephrology Service, Walter Reed Army Medical Center (WRAMC), Washington, DC, and Uniformed Services University School of the Health Sciences, Bethesda, MD; Organ Transplant Service, WRAMC, Washington, DC, and National Institutes of Health, Bethesda, MD; NIDDK, National Institutes of Health, Bethesda, MD; and Division of Kidney Diseases and Hypertension, Department of Medicine, George Washington University Medical Center, Washington, DC.

Correspondence to Dr. Kevin C. Abbott, Nephrology Service, Walter Reed Army Medical Center, Washington, DC 20307-5001. Phone: 202-782-6462/6463/6288; Fax: 202-782-0185; E-mail: kevin.abbott{at}na.amedd.army.mil

ABSTRACT. Before the era of highly active antiretroviral therapy, kidney transplant recipients infected with HIV had increased risk of death compared with HIV-uninfected recipients. More recent single-center reports have indicated improved results, but this has not been assessed in a national population. Therefore, a retrospective cohort study of US adult deceased donor kidney transplant recipients from January 1, 1996, to May 31, 2001 was conducted; patients were followed until October 31, 2001. A total of 27,851 patients had valid recipient HIV serology. Cox regression analysis was used to model adjusted hazard ratios for mortality and graft loss, respectively, adjusted for other factors, including comorbid conditions from Centers for Medicare and Medicaid Studies Form 2728. Factors independently associated with HIV infection were also assessed by logistic regression analysis. Only 12.8% of HIV-infected recipients were black, compared with 27.6% in the entire study cohort. HIV-infected kidney transplant recipients were significantly less likely to be black in logistic regression analysis (adjusted OR, 0.29; 95% CI, 0.08 to 0.99; P = 0.049), which was the only factor independently associated with HIV infection. It was found that HIV-infected recipients had improved survival compared with HIV-uninfected recipients, although this was not statistically significant in adjusted analysis (adjusted HR, 0.36; 95% CI, 0.05 to 2.53; P = 0.31). Kidney transplantation in HIV-infected patients is plausible and ongoing, but HIV-infected candidates who underwent kidney transplantation in the United States during the course of the study were demographically unrepresentative of HIV-infected candidates generally.

This article has been cited by other articles:

				G. C. Persad, R. F. Little, and C. Grady Including Persons With HIV Infection in Cancer Clinical Trials J. Clin. Oncol., March 1, 2008; 26(7): 1027 - 1032. [Full Text] [PDF]

				B. C. Weikert and E. A. Blumberg Viral Infection after Renal Transplantation: Surveillance and Management Clin. J. Am. Soc. Nephrol., March 1, 2008; 3(Supplement_2): S76 - S86. [Abstract] [Full Text] [PDF]

				J. S. Berns and N. Kasbekar Highly Active Antiretroviral Therapy and the Kidney: An Update on Antiretroviral Medications for Nephrologists Clin. J. Am. Soc. Nephrol., January 1, 2006; 1(1): 117 - 129. [Abstract] [Full Text] [PDF]

				K. L. Lentine, D. C. Brennan, and M. A. Schnitzler Incidence and Predictors of Myocardial Infarction after Kidney Transplantation J. Am. Soc. Nephrol., February 1, 2005; 16(2): 496 - 506. [Abstract] [Full Text] [PDF]

Copyright © 2008 by the American Society of Nephrology. Online ISSN: 1533-3450 Print ISSN: 1046-6673