Recurrent HIV-Associated Immune Complex Glomerulonephritis With Lupus-like Features After Kidney Transplantation

Chandran, Sindhu; Jen, Kuang-Yu; Lászik, Zoltán

doi:10.1053/j.ajkd.2013.01.010

Cited by 9 publications

(3 citation statements)

References 22 publications

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“…Among the various case reports [ 36 , 37 , 38 , 39 , 40 ], two cases show interesting results in terms of therapeutic modalities. Matignon et al [ 41 ], in 2005, and Yang et al [ 39 ], in 2014, described two cases in which complete remission was achieved only using HAART therapy, while a case report by Chandran et al [ 42 ] described a kidney transplant HIV patient with recurrent HIV-associated lupus-like nephritis whose kidney function has remained stable, even though no specific therapy was instituted.…”

Section: Discussionmentioning

confidence: 99%

Treatment of HIV-Associated Lupus-like Membranous Nephropathy with Tacrolimus: A Case Report and Review of the Literature

Kofotolios

Tsiakas

Skalioti

et al. 2023

Life

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Renal complications of HIV infection are common and histologically diverse. Besides HIV-associated nephropathy, which is the most well-defined glomerular disorder, immune-complex-mediated glomerulonephritis (HIVICK) is also encountered in the setting of HIV infection and may occasionally present with “lupus-like” features by light microscopy and immunofluorescence. Management of HIVICK remains controversial and mainly focuses on HIV viremia suppression with combined antiretroviral therapy. Immunosuppressive therapy may be used in order to mitigate the renal inflammation induced by the immune complex deposition. Data regarding the use of immunosuppressants in HIVICK are very limited, mostly including corticosteroids and mycophenolate acid analogues. Herein, we present the case of a 40-year-old HIV-infected Caucasian man with nephrotic syndrome, renal impairment, and a “lupus-like” membranous pattern in the kidney biopsy, who achieved a partial response of his proteinuria with a tacrolimus-based regimen in combination with antiretroviral therapy.

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Section: Discussionmentioning

confidence: 99%

Treatment of HIV-Associated Lupus-like Membranous Nephropathy with Tacrolimus: A Case Report and Review of the Literature

Kofotolios

Tsiakas

Skalioti

et al. 2023

Life

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“…Indeed, in a study by Locke et al (12) comparing the survival of HIVpositive grafts with that of HIV-negative subjects in a ratio of 1/10, the graft survival at 5-year was 69.2% versus 75.3% and that of 10 years was 49.8% versus 54.4%. The survival of the graft in the transplanted HIV-positive patient depends on at least three factors; the incidence of acute rejection known to be high (7,8), the recurrence of the virus on graft whether histological (8) or clinical (13) and the renal toxicity of antiretrovirals in particular by tenofovir (14). The renal toxicity of tenofovir is complex and not yet fully elucidated.…”

Section: Graft Survival In Hiv-positive Renal Transplant Recipientsmentioning

confidence: 99%

Renal transplant in human immunodeficiency virus positive dialysis patients; report of four cases in French-speaking sub-Saharan Africa and review of literature

Lagou¹,

Ackoundou-N’Guessan²,

Coulibaly³

et al. 2018

Immunopathol Persa

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Quality of life and life span have considerably increased in human immunodeficiency virus (HIV) patients over the past years owing to the highly effective antiretroviral therapy. Consequently, the number of patients with end-stage renal disease (ESRD) has increased in dialysis centers. Several teams in the United States as well as in Europe have therefore proposed renal transplantation to this group of patients with encouraging results. From March 2015 to February 2016, four kidney transplantations have been conducted in the very first kidney transplantation program ever in French speaking black Africa. Three male and one female with a mean age of 50.75 years have been transplanted. One of them was HIV-2 positive. Before kidney transplantation, patients have exhibited diverse highly active antiretroviral therapy (HAART) regimen. They all have undetectable viremia and the mean value of the CD4 count was 454.5 cells/µL. Raltegravir, an integrase inhibitor, has systematically been added to the baseline HAART therapy at least 30 days before transplantation. Immunosuppression comprised basiliximab as induction therapy, tacrolimus, sodium mycophenolate and steroids. After a mean time of six months, all the patients are alive with a mean serum creatinine of 1.425±0.263mg/dl, and a mean proteinuria of 0.55±0.29 g/d. We present these results in full, and discuss them according to data retrieved from the literature. The conditions of access of human immunodeficiency virus positive patients to renal transplantation, the immunosuppression and the antiretroviral regimen, graft and patient survival have all been discussed accordingly.

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“…Whether traditional criteria for organ quality will be adequate to accurately assess organ quality, or whether more sensitive measures will be needed to predict outcomes when HIV+ donors are used, is unknown. In addition, there is some evidence from transplantation with HIV− donors that, despite effective ART in the HIV+ recipient, HIV may directly infect kidney allografts and lead to kidney damage or even HIVAN recurrence . This may be compounded in the setting of HIV+ donors and also raises the theoretic risk of compartmentalization, viral recombination and development of ART resistance.…”

Section: Introductionmentioning

confidence: 99%

Challenges and Clinical Decision-Making in HIV-to-HIV Transplantation: Insights From the HIV Literature

Boyarsky¹,

Durand²,

Palella

et al. 2015

American Journal of Transplantation

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Life expectancy among HIV‐infected (HIV+) individuals has improved dramatically with effective antiretroviral therapy. Consequently, chronic diseases such as end‐stage liver and kidney disease are growing causes of morbidity and mortality. HIV+ individuals can have excellent outcomes after solid organ transplantation, and the need for transplantation in this population is increasing. However, there is a significant organ shortage, and HIV+ individuals experience higher mortality rates on transplant waitlists. In South Africa, the use of organs from HIV+ deceased donors (HIVDD) has been successful, but until recently federal law prohibited this practice in the United States. With the recognition that organs from HIVDD could fill a critical need, the HIV Organ Policy Equity (HOPE) Act was passed in November 2013, reversing the federal ban on the use of HIV+ donors for HIV+ recipients. In translating this policy into practice, the biologic risks of using HIV+ donors need to be carefully considered. In this mini‐review, we explore relevant aspects of HIV virology, antiretroviral treatment, drug resistance, opportunistic infections and HIV‐related organ dysfunction that are critical to a transplant team considering HIV‐to‐HIV transplantation.

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Recurrent HIV-Associated Immune Complex Glomerulonephritis With Lupus-like Features After Kidney Transplantation

Cited by 9 publications

References 22 publications

Treatment of HIV-Associated Lupus-like Membranous Nephropathy with Tacrolimus: A Case Report and Review of the Literature

Treatment of HIV-Associated Lupus-like Membranous Nephropathy with Tacrolimus: A Case Report and Review of the Literature

Renal transplant in human immunodeficiency virus positive dialysis patients; report of four cases in French-speaking sub-Saharan Africa and review of literature

Challenges and Clinical Decision-Making in HIV-to-HIV Transplantation: Insights From the HIV Literature

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