• A R Vicari, F Spuldaro, T V Sandes-Freitas, M P Cristelli, L R Requião-Moura, J O Reusing, L C Pierrotti, M L Oliveira, C M Girão, G Gadonski, L V Kroth, L M Deboni, G F Ferreira, H Tedesco-Silva, R Esmeraldo, E David-Neto, D Saitovitch, E Keitel, V D Garcia, A Pacheco-Silva, J O Medina-Pestana, and R C Manfro.
• Renal Transplant Unit, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
• Transpl Infect Dis. 2016 Oct 1; 18 (5): 730-740.

BackgroundHighly 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.MethodsHIV-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.ResultsFifty-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.ConclusionsIn the Brazilian experience, despite somewhat inferior outcomes, kidney transplantation is an adequate therapy for selected HIV-infected recipients.© 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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