University of Michigan Medical Center, Ann Arbor, MI 48109, USA.
AIDS Rev. 2012 Jul-Sep;14(3):195-207.
HIV infection has historically been a contraindication to kidney transplantation. Prior to the era of potent antiretroviral therapy, the survival of HIV-infected patients was too poor to justify transplantation. In the last 15 years there has been substantial improvement in antiretroviral medications, such that HIV-positive patients are living longer and developing chronic diseases such as end-stage renal disease. The improvement in survival of HIV-positive patients has resulted in transplant centers increasingly considering infected patients appropriate for kidney transplantation. Recently, the results of the first prospective multicenter trial of kidney transplantation into HIV-positive candidates were released, showing the success and challenges of transplantation into this population. In light of the multicenter findings as well as national registry data, kidney transplantation should be considered the standard-of-care renal replacement therapy for HIV-positive end-stage renal disease patients and they should be referred and evaluated for kidney transplantation accordingly.
HIV 感染在历史上一直是肾移植的禁忌症。在强效抗逆转录病毒治疗时代之前，HIV 感染者的生存率太低，无法进行移植。在过去的 15 年中，抗逆转录病毒药物有了实质性的改进，使得 HIV 阳性患者的寿命更长，并出现了终末期肾病等慢性疾病。HIV 阳性患者的生存率提高，导致移植中心越来越多地考虑将感染患者视为适合肾移植的对象。最近，首例前瞻性多中心 HIV 阳性候选者肾移植试验的结果发布，展示了该人群移植的成功和挑战。鉴于多中心的研究结果以及国家登记数据，肾移植应被视为 HIV 阳性终末期肾病患者的标准肾脏替代治疗方法，应相应地对他们进行转介和评估，以进行肾移植。
