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Current HIV/AIDS Reports
Published in: Current HIV/AIDS Reports 3/2019

01-06-2019 | Opportunistic Infection | HIV Pathogenesis and Treatment (AL Landay and NS Utay, Section Editors)

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

Authors: William A. Werbel, Christine M. Durand

Published in: Current HIV/AIDS Reports | Issue 3/2019

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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.

Summary

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.
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Metadata
Title
Solid Organ Transplantation in HIV-Infected Recipients: History, Progress, and Frontiers
Authors
William A. Werbel
Christine M. Durand
Publication date
01-06-2019
Publisher
Springer US
Published in
Current HIV/AIDS Reports / Issue 3/2019
Print ISSN: 1548-3568
Electronic ISSN: 1548-3576
DOI
https://doi.org/10.1007/s11904-019-00440-x

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