Journal article
Infections After Kidney Transplantation From Donors With Human Immunodeficiency Virus (HIV) to Recipients With HIV
Clinical infectious diseases, 9203213
12 Jan 2026
PMID: 41524130
Featured in Collection : Drexel's Newest Publications
Abstract
Background Kidney transplantation (KT) from donors with human immunodeficiency virus (HIV-1) to recipients with HIV (HIV D+/R+) is noninferior to KT from donors without HIV (HIV D-/R+) with regard to safety. However, there may be differences in posttransplant infections.Methods We performed a secondary analysis of the HOPE in Action KT Study (NCT02602262) comparing the time to first clinically relevant infection within 24 months posttransplantation in 99 HIV D+/R+ versus 99 HIV D-/R+. Secondary outcomes included incidence rates, infection-related death, and timing of clinically relevant infection, each stratified by donor HIV status.Results The cumulative incidence of a clinically relevant infection at 24 months posttransplantation was 73.8% (95% confidence interval [CI]: 63.1%-81.2%) for HIV D+/R+ versus 64.7% (95% CI: 53.0%-73.4%) for HIV D-/R+. Comparing time to first clinically relevant infection in HIV D+/R+ versus HIV D-/R+, the adjusted hazard ratio (aHR) was 1.44 (95% CI: 1.01-2.04) at 24 months posttransplantation; for infections associated with hospitalization, the aHR was not significantly higher (1.21 [95% CI: .78-1.86). There were no significant differences in the number of infections, death from infection, duration, or site of infection between HIV D+/R+ versus HIV D-/R+, though viral infections were numerically more common in HIV D+/R+ (40% vs 35%).Conclusions Although there was a statistically significant association between receipt of a kidney from a donor with HIV and time to first clinically relevant infection in the 24 months posttransplantation, there were no differences in infections associated with hospitalization. These data are overall reassuring as this emerging practice expands into clinical care. Clinical Trials Registration. NCT02602262.Conclusions Although there was a statistically significant association between receipt of a kidney from a donor with HIV and time to first clinically relevant infection in the 24 months posttransplantation, there were no differences in infections associated with hospitalization. These data are overall reassuring as this emerging practice expands into clinical care. Clinical Trials Registration. NCT02602262.
Among 198 kidney transplant recipients with HIV, the rate and spectrum of posttransplant infections were similar regardless of donor HIV status. HIV donor-positive recipients had modestly higher risk of clinically relevant infections in survival analyses, but not for infections associated with hospitalization.
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Details
- Title
- Infections After Kidney Transplantation From Donors With Human Immunodeficiency Virus (HIV) to Recipients With HIV
- Creators
- Elizabeth C. Arant (Corresponding Author) - University of North Carolina at Chapel HillThibaut Davy-Mendez - University of North Carolina at Chapel HillTao Liang - Johns Hopkins UniversityMoreno Rodrigues - Johns Hopkins MedicineCynthia L. Gay - University of North Carolina at Chapel HillMeenakshi M. Rana - Icahn School of Medicine at Mount SinaiRachel Friedman-Moraco - Emory UniversityAlexander Gilbert - Georgetown UniversityPeter Stock - University of California, San FranciscoSapna A. Mehta - NYU Langone Transplant Inst, Dept Med, New York, NY USAShikha Mehta - University of Alabama at BirminghamValentina Stosor - Northwestern UniversityMarcus R. Pereira - Columbia University Irving Medical CenterMichele Morris - University of MiamiJonathan Hand - Ochsner Health SystemSaima Aslam - University of California San DiegoMaricar Malinis - College Station Medical CenterGhady Haidar - University of PittsburghCatherine B. Small - Cornell UniversityCarlos A. Q. Santos - Rush University Medical CenterJoanna Schaenman - University of California, Los AngelesJohn W. Baddley - Johns Hopkins UniversityDavid Wojciechowski - The University of Texas Southwestern Medical CenterEmily A. Blumberg - University of PennsylvaniaKarthik Ranganna - Drexel UniversityOluwafisayo Adebiyi - Indiana University – Purdue University IndianapolisNahel Elias - Massachusetts General HospitalJose A. Castillo-Lugo - Houston MethodistEmmanouil Giorgakis - College Station Medical CenterSenu Apewokin - University of Cincinnati Medical CenterMegan Morsheimer - National Institute of Allergy and Infectious DiseasesChristian van Delden - Univ Hosp Geneva, Serv Infect Dis, Transplant Infect Dis Unit, Geneva, SwitzerlandOriol Manuel - University of LausanneNicolas J. Mueller - Univ Hosp Zurich, Div Infect Dis & Hosp Epidemiol, Zurich, SwitzerlandDionysios Neofyotos - Geneva CollegeAaron A. R. Tobian - Johns Hopkins MedicineAllan Massie - NYU Langone HealthDorry L. Segev - NYU Langone HealthWilliam Werbel - Johns Hopkins MedicineChristine M. Durand - Johns Hopkins Medicine
- Publication Details
- Clinical infectious diseases, 9203213
- Publisher
- Oxford University Press
- Number of pages
- 9
- Grant note
- R01 AI120938; R01DK131926; U01AI138897; U01AI134591; U01AI177211; K23AI157893 / National Institutes of Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Medicine (Graduate)
- Web of Science ID
- WOS:001659305000001
- Other Identifier
- 991022154843104721