Session Time: 6:00pm-7:00pm
Presentation Time: 6:05pm-6:10pm
*Purpose: Transplantation of HIV+ individuals has become more common over the past decade with increasing data supporting good outcomes. Questions remain regarding the impact of induction and antiretroviral (ARV) choice on long-term outcomes.
*Methods: We performed a multicenter retrospective analysis of outcomes in HIV+ kidney transplant (KT) recipients from 2004-2019. Recipients of HIV + donors and kidneys with primary non-function were excluded. Outcomes included rejection, graft and patient survival stratified by induction immunosuppression and ARV regimen.
*Results: There were 78 KT in 77 patients at 5 US transplant centers. Clinical characteristics and outcomes are shown in Table 1. Rejection at any time occurred in 38% (30/78 KT). Those with rejection were more likely to be younger, African American, and to have received a deceased donor kidney (all p<0.05). Among 78 the transplants, 29 were on a protease inhibitor (PI) at KT; 11 of 29 (37%) switched to non-PI-based ARVs. This occurred more frequently after 2009 (58.8%) compared to before 2009 (8.3%). The lowest rates of rejection and highest graft survival were seen in recipients who received Anti-thymocyte globulin (rabbit) (rATG) induction and were on non-PI-based ARVs as illustrated in Figure 1a and Figure 1b. Among those receiving rATG, there was a trend to higher rejection and graft loss in those on PI-based ARV (p=0.07). There were no differences in death-censored graft loss or patient survival.
*Conclusions: Our results align with previous studies showing a benefit of rATG and non-PI-based ARVs on KT outcomes. Results from this study may influence selection of ARV regimens and induction therapy in HIV+ kidney transplant recipients.
To cite this abstract in AMA style:Marks CRogers, Durand C, Hand J, Abidi M, Malinis M, Barnaba B, Patel H, Alonso CD. Influence of Induction Therapy and Antiretroviral Regimen on Outcomes in HIV Positive Renal Transplant Recipients [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/influence-of-induction-therapy-and-antiretroviral-regimen-on-outcomes-in-hiv-positive-renal-transplant-recipients/. Accessed June 12, 2021.
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