Date: Saturday, May 30, 2020
Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
*Purpose: Kidney allograft survival in HIV-infected patients is lower than in the general population. Belatacept (instead of anticalcineurins (CNI)) has been shown to have a benefit in terms of long-term survival of patients and kidney allografts. Its use in transplanted HIV+ patients is currently poorly documented.
*Methods: All French kidney transplant centres were contacted and all HIV+ patients treated with belatacept were analyzed retrospectively. We studied patient survival, allograft survival, HIV disease progression, incidence of acute rejection and opportunistic infections, and evolution of donor-specific anti-HLA antibodies (DSA).
*Results: Twelve patients were included in the study: 2 (16%) belatacept de novo and 10 (84%) CNI-belatacept switch 10 [2-30] months after transplantation. 12-months after treatment, patients’ and kidney allograft survivals were 91%. HIV infection remained controlled outside 2 (17%) reactivations (therapeutic non-compliance). Two (17%) acute corticosteroid-resistant T-cell mediated rejection, 2 months and 2 years after the switch, were identified and followed by a loss of the kidney allograft. Two (17%) opportunistic infections, tuberculosis with macrophage activation syndrome and norovirus diarrhea, have been reported in two patients within three months of treatment. DSAs were stable at 12 months of treatment. Estimated glomerular filtration rate (eGFR) increased significantly 12-months after switch and at the end of follow-up (P=0.02, P=0.0002).
*Conclusions: After kidney transplantation, in HIV+ patients, belatacept use as a replacement for CNI is safe and increased significantly eGFR. A study with more patients and longer follow-up is needed to better define the place of belatacept in HIV+ kidney transplant recipients.
To cite this abstract in AMA style:Sakhawi KEl, Scemla A, Bertrand D, Garrouste C, Malvezzi P, Grimbert P, Matignon M. Safety of Belatacept in HIV-Positive Kidney Transplant Recipients [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/safety-of-belatacept-in-hiv-positive-kidney-transplant-recipients/. Accessed August 13, 2020.
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