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Kidney transplant survival rate found worse in recipients with HCV vs. HIV

Kidney transplant recipients that were positive for HIV had a greater survival rate vs. kidney transplant recipients with hepatitis C virus infection and recipients coinfected with HIV and hepatitis C virus infection, according to new study data.

“These findings show that HIV patients are being unfairly perceived to have worse kidney transplant outcomes than noninfected groups, and as a result, they often have to wait the longest for transplants and there are fewer living donors,” Deirdre Sawinksi, MD, assistant professor in the division of renal, electrolyte and hypertension at the Perelman School of Medicine, University of Pennsylvania, said in a press release. “Our hope is that these study findings result in greater access to transplantation for HIV patients, while also inspiring the kidney transplant community to focus on eradicating hepatitis C in transplant patients — either pre-transplant or if that’s not possible, immediately post-transplant — to ensure better outcomes for these patients.”

Sawinski and colleagues evaluated outcomes of 124,035 adult kidney transplant recipients who underwent transplantation between 1996 and 2013. Of these patients, 492 were HIV-positive, 5,605 were HCV-positive and 147 were HIV/HCV coinfected. An uninfected patient reference group of 117,791 was also used in the study.

The 3-year survival rate for recipients with HIV was 89%, which was greater than recipients with HCV (84%) and recipients coinfected with HIV and HCV (73%). The survival rate of HIV-infected recipients was similar to the survival rate of the uninfected patient reference group (90%).

Three-year allograft survival was highest in the HIV-monoinfected recipients and uninfected recipients (81%, 86%) compared with the recipients with HCV (78%) and recipients coinfected with HIV/HCV (60%; P < .001).

According to the research, HIV did not adversely affect recipient or allograft survival among this cohort.

“Under current U.S. kidney transplant practice, HIV monoinfection does not adversely affect recipient or allograft survival and is associated with superior outcomes compared with both HCV monoinfection and HIV/HCV coinfection in this population,” the researchers concluded. “Investigation of pretransplant or immediate post-transplant viral eradication with contemporary therapies should be prioritized as a strategy to improve post-transplant outcomes in HCV-infected kidney recipients.” – by Melinda Stevens

Disclosure: The researchers report no relevant financial disclosures.