Solid Organ Transplantation in HIV-Infected Recipients: History, Progress, and Frontiers.

Abstract:

PURPOSE OF REVIEW:End-stage organ disease prevalence is increasing among HIV-infected (HIV+) individuals. Trial and registry data confirm that solid organ transplantation (SOT) is efficacious in this population. Optimizing access to transplant and decreasing complications represent active frontiers. RECENT FINDINGS:HIV+ recipients historically experienced 2-4-fold higher rejection. Integrase strand transferase inhibitors (INSTIs) minimize drug interactions and may reduce rejection along with lymphodepleting induction immunosuppression. Hepatitis C virus (HCV) coinfection has been associated with inferior outcomes, yet direct-acting antivirals (DAAs) may mitigate this. Experience in South Africa and the US HIV Organ Policy Equity (HOPE) Act support HIV+ donor to HIV+ recipient (HIV D+/R+) transplantation. SOT is the optimal treatment for end-stage organ disease in HIV+ individuals. Recent advances include use of INSTIs and DAAs in transplant recipients; however, strategies to improve access to transplant are needed. HIV D+/R+ transplantation is under investigation and may improve access and provide insights for HIV cure and pathogenesis research.

journal_name

Curr HIV/AIDS Rep

journal_title

Current HIV/AIDS reports

authors

Werbel WA,Durand CM

doi

10.1007/s11904-019-00440-x

subject

Has Abstract

pub_date

2019-06-01 00:00:00

pages

191-203

issue

3

eissn

1548-3568

issn

1548-3576

pii

10.1007/s11904-019-00440-x

journal_volume

16

pub_type

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