Direct-Acting Antiretroviral Therapy in Renal Transplant Recipients With Human Immunodeficiency Virus–Hepatitis C Virus Coinfection: Report of Our Experience and Literature Review

Moreno‐Ramirez, Manuela; Villanego, Florentino; Vigara, Luis Alberto; Cazorla, Juan Manuel; Naranjo, Javier; García, Teresa Martín; Merino, MaríaDolores; Mazuecos, Auxiliadora

doi:10.1016/j.transproceed.2019.12.009

Cited by 1 publication

(1 citation statement)

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“…Historically, solid organ transplant in PLHIV resulted in a higher risk of rejection compared with non-HIV patients owing to drug–drug interactions and inferior outcomes for HIV/HCV-coinfected recipients. Rejection risk improved with key developments including direct-acting antivirals that mitigate risk imposed by HCV infection [ 80 , 81 ], and avoidance or modification of ART regimens interacting with immunosuppressant therapy [ 82 – 84 ]. Graft survival and patient survival rates of renal transplant in HIV positive mono-infected patients are the same as in non-HIV transplant patients; studies that include HCV-coinfected patients show slightly worse survival in the pre-Direct Acting Antiviral (DAA) era [ 85 – 87 ].…”

Section: Are Responses* To Using Systemic Psoriasis Therapies For Tre...mentioning

confidence: 99%

Use of Systemic Therapies for Treatment of Psoriasis in People Living with Controlled HIV: Inference-Based Guidance from a Multidisciplinary Expert Panel

Papp

Beecker

Cooper

et al. 2022

Dermatol Ther (Heidelb)

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Background People living with human immunodeficiency virus (PLHIV) have a similar prevalence of psoriasis as the general population, though incidence and severity correlate with HIV viral load. Adequately treating HIV early renders the infection a chronic medical condition and allows PLHIV with a suppressed viral load (PLHIV-s) to live normal lives. Despite this, safety concerns and a lack of high-level data have hindered the use of systemic psoriasis therapies in PLHIV-s. Objectives We aim to provide a structured framework that supports healthcare professionals and patients discussing the risks and benefits of systemic psoriasis therapy in PLHIV-s. Our goal was to address the primary question, are responses to systemic therapies for the treatment of psoriasis in PLHIV-s similar to those in the non-HIV population? Methods We implemented an inference-based approach relying on indirect evidence when direct clinical trial data were absent. In this instance, we reviewed indirect evidence supporting inferences on the status of immune function in PLHIV. Recommendations on systemic treatment for psoriasis in PLHIV were derived using an inferential heuristic. Results We identified seven indirect indicators of immune function informed by largely independent bodies of evidence: (1) functional assays, (2) vaccine response, (3) life expectancy, (4) psoriasis manifestations, (5) rate of infections, (6) rate of malignancies, and (7) organ transplant outcomes. Conclusions Drug-related benefits and risks when treating a patient with systemic psoriasis therapies are similar for non-HIV patients and PLHIV with a suppressed viral load and normalized CD4 counts. Prior to initiating psoriasis treatment in PLHIV, HIV replication should be addressed by an HIV specialist. Exercise additional caution for patients with a suppressed viral load and discordant CD4 responses on antiretroviral therapy. Supplementary Information The online version contains supplementary material available at 10.1007/s13555-022-00722-0.

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Section: Are Responses* To Using Systemic Psoriasis Therapies For Tre...mentioning

confidence: 99%

Use of Systemic Therapies for Treatment of Psoriasis in People Living with Controlled HIV: Inference-Based Guidance from a Multidisciplinary Expert Panel

Papp

Beecker

Cooper

et al. 2022

Dermatol Ther (Heidelb)

View full text Add to dashboard Cite

show abstract

Direct-Acting Antiretroviral Therapy in Renal Transplant Recipients With Human Immunodeficiency Virus–Hepatitis C Virus Coinfection: Report of Our Experience and Literature Review

Cited by 1 publication

References 10 publications

Use of Systemic Therapies for Treatment of Psoriasis in People Living with Controlled HIV: Inference-Based Guidance from a Multidisciplinary Expert Panel

Use of Systemic Therapies for Treatment of Psoriasis in People Living with Controlled HIV: Inference-Based Guidance from a Multidisciplinary Expert Panel

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