Solid organ transplantation in HIV‐infected individuals: an update

Huprikar, Shirish

doi:10.1002/rmv.620

Cited by 10 publications

(7 citation statements)

References 37 publications

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“…[6][7][8][9] Despite these concerns, several studies over the last decade demonstrated that HIV-positive individuals had comparable graft and patient survival as HIV-negative liver and kidney transplant recipients with HIV-uninfected organs. [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] However, much less is known about the risks and benefits of HIV-positive transplant recipients of heart, lung, or pancreas transplant as few of these surgeries have been performed to date. 5,[25][26][27][28][29][30][31][32] With the advent of antiretroviral therapies (ART), HIV has been reclassified as a chronic disease.…”

Section: B Rief His Tory Of Hiv-p Os Itive To Hiv-p Os Itive Tr An mentioning

confidence: 99%

Transplant advocacy in the era of the human immunodeficiency virus organ policy equity act

Steel

Gordon

Dulovich

et al. 2018

Clinical Transplantation

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In 2013, the Human Immunodeficiency Virus Organ Policy Equity (HOPE) Act was passed to permit the conduct of research on the transplantation of organs from donors infected with human immunodeficiency virus (HIV) into recipients who are HIV-positive. The HOPE Act workshop had many objectives including the discussion of the ethical issues involved in HIV-positive to HIV-positive transplantation, the informed consent process, and the role of independent advocates in the context of HIV to HIV transplantation. As of 2018, 22 transplant hospitals are approved, or undergoing approval, to perform HIV-positive to HIV-positive transplant surgeries, and this number is expected to grow. This study aims to: (i) briefly review the history and research of HIV+ transplantation prior to the HOPE Act, (ii) describe the ethical principles supporting the HOPE Act, (iii) characterize the informed consent process, and (iv) provide guidance regarding the role of independent advocates in the context of HIV-positive to HIV-positive transplantation.

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Section: B Rief His Tory Of Hiv-p Os Itive To Hiv-p Os Itive Tr An mentioning

confidence: 99%

Transplant advocacy in the era of the human immunodeficiency virus organ policy equity act

Steel

Gordon

Dulovich

et al. 2018

Clinical Transplantation

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“…467, 468 However, potent immunosuppressive therapy has been used successfully in HIV-infected individuals undergoing organ transplantation for nearly two decades, with no significant increase in risk for these complications in comparison with such complications in HIV-negative transplant recipients. 469–472 Several studies have reported that HIV viral loads and CD4+ T-lymphocyte counts were well-maintained after kidney and liver transplantation in HIV-infected patients. 473–475 Moreover, the largest prospective study of cART-treated HIV-infected recipients of kidney transplantation (n = 150) receiving standard immunosuppressive therapy reported one and three year survival rates to be 94.6% and 88.2% 475 , respectively, which is not significantly different from current kidney transplant survival rates as reported by the U.S. Scientific Registry of Transplant Recipients.…”

Section: Faes As Adjunctive Therapy For Hiv Infectionmentioning

confidence: 99%

Dimethyl Fumarate Modulation of Immune and Antioxidant Responses: Application to HIV Therapy

Gill

Kolson

2013

Crit Rev Immunol

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The persistence of chronic immune activation and oxidative stress in human immunodeficiency virus (HIV)-infected, antiretroviral drug-treated individuals are major obstacles to fully preventing HIV disease progression. The immune modulator and antioxidant dimethyl fumarate (DMF) is effective in treating immune-mediated diseases and it also has potential applications to limiting HIV disease progression. Among the relevant effects of DMF and its active metabolite monomethyl fumarate (MMF) are induction of a Th1 → Th2 lymphocyte shift, inhibition of pro-inflammatory cytokine signaling, inhibition of NF-κB nuclear translocation, inhibition of dendritic cell maturation, suppression of lymphocyte and endothelial cell adhesion molecule expression, and induction of the Nrf2-dependent antioxidant response element (ARE) and effector genes. Associated with these effects are reduced lymphocyte and monocyte infiltration into psoriatic skin lesions in humans and immune-mediated demyelinating brain lesions in rodents, which confirms potent systemic and central nervous system (CNS) effects. In addition, DMF and MMF limit HIV infection in macrophages in vitro, albeit by unknown mechanisms. Finally, DMF and MMF also suppress neurotoxin production from HIV-infected macrophages, which drives CNS neurodegeneration. Thus, DMF might protect against systemic and CNS complications in HIV infection through its effective suppression of immune activation, oxidative stress, HIV replication, and macrophage-associated neuronal injury.

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“…Although more rapid deterioration in HIV coinfected patients may be the cause [37] , death in that study was not associated with MELD, viral load, CD4, ability to tolerate medications or HCV progression. Further studies are necessary to understand the risk factors for death in HIV-positive patients on the liver transplant waiting list [38] . The inclusion criteria of an NIH sponsored study in the USA [39] are AIDS-related opportunistic infections or cancers that are resolved by sufficient treatment prior to transplant.…”

Section: Hcv Management Before Transplantationmentioning

confidence: 99%

Liver transplantation in HCV/HIV positive patients

Sugawara

Tamura²,

Kokudo³

2011

WJGS

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Since the introduction of highly active antiretroviral the rapy (HAART) in 1996 for human immunodeficiency virus (HIV)infected patients, the incidence of liver diseases secondary to coinfection with hepatitis C has increased. Although data on the outcome of liver transplantation in HIVinfected recipients is limited, the overall results to date seem to be comparable to that in nonHIVinfected recipients. Liver transplant centers are now accepting HIVinfected individuals as organ recipients. Posttransplantation HIV replication is con trolled by HAART. Hepatitis C reinfection of the liver graft, however, remains an important problem because cirrhotic changes of the liver graft may be more rapid in HIVinfected recipients. Interactions between the HAART components and immunosuppressive drugs influence drug metabolism and therefore meticulous monitoring of drug blood level concentrations is required. The risk of opportunistic infection in HIVpositive transplant pa tients seems to be similar to that in HIVnegative trans plant recipients.

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Solid organ transplantation in HIV‐infected individuals: an update

Cited by 10 publications

References 37 publications

Transplant advocacy in the era of the human immunodeficiency virus organ policy equity act

Transplant advocacy in the era of the human immunodeficiency virus organ policy equity act

Dimethyl Fumarate Modulation of Immune and Antioxidant Responses: Application to HIV Therapy

Liver transplantation in HCV/HIV positive patients

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