Infections in solid organ transplant HIV-infected patients.


Journal Article (Review)

Solid organ transplantation (SOT) is an appropriate therapeutic option for HIV-infected patients with end-stage organ disease. Recent experience in North America and Europe indicates that 3- to 5-year survival in HIV/HCV-coinfected liver recipients is lower than that of HCV-monoinfected recipients. Conversely, 3- to 5-year survival of non-HCV-coinfected transplant patients (liver, kidney and heart) was similar to that of non-HIV-infected patients. Preliminary experience with lung transplantation and combined kidney and pancreas transplantation is also satisfactory. Infections in HIV-infected recipients during the post-transplant period are similar to those seen in non-HIV-infected patients, although the incidence rates of tuberculosis and fungal infections seem to be higher. HIV-infected patients who are being evaluated for SOT should follow the same recommendations as those used for non-HIV-infected patients in order to prevent infections during the pre-transplant period. After transplantation, HIV-infected SOT recipients must follow recommendations on post-SOT and anti-HIV immunization and on antimicrobial prophylaxis. The recommended antiretroviral regimen is one based on raltegravir or dolutegravir plus two nucleos(t)ide reverse transcriptase inhibitors (tenofovir + emtricitabine or abacavir + lamivudine), because it can prevent pharmacokinetic interactions between antiretroviral drugs, immunosuppressive drugs and some of the antimicrobial agents used to treat or prevent post-transplant infections. In this manuscript, we review current recommendations for preventing infections both before and after transplantation. We also analyse the incidence, aetiology and clinical characteristics of opportunistic and non-opportunistic bacterial, mycobacterial, fungal and viral infections in HIV-infected SOT recipients during the post-transplant period.

Full Text

Cited Authors

  • Miro, JM; Agüero, F; Duclos-Vallée, J-C; Mueller, NJ; Grossi, P; Moreno, A; ESCMID Study Group of Infection in Compromised Hosts,

Published Date

  • September 2014

Published In

Volume / Issue

  • 20 Suppl 7 /

Start / End Page

  • 119 - 130

PubMed ID

  • 25040016

Pubmed Central ID

  • 25040016

Electronic International Standard Serial Number (EISSN)

  • 1469-0691

International Standard Serial Number (ISSN)

  • 1198-743X

Digital Object Identifier (DOI)

  • 10.1111/1469-0691.12754


  • eng