Renal Electrolyte and Hypertension Division, Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Clin Transplant. 2020 Oct;34(10):e14048. doi: 10.1111/ctr.14048. Epub 2020 Aug 29.
Human immunodeficiency virus (HIV), hepatitis C (HCV), and hepatitis B (HBV) are common chronic viral infections in the end-stage kidney disease (ESKD) patient population that were once considered relative contraindications to kidney transplantation. In this review, we will summarize the current state of kidney transplantation in patients with HIV, HCV, and HBV, which is rapidly evolving. HIV+ patients enjoy excellent outcomes in the modern transplant era and may have new transplant opportunities with the use of HIV+ donors. Direct-acting antivirals for HCV have substantially changed the landscape of care for patients with HCV infection. HBV+ patients now have excellent patient and allograft survival with HBV therapy. Currently, kidney transplantation is a safe and appropriate treatment for the majority of ESKD patients with HIV, HCV, and HBV.
人类免疫缺陷病毒 (HIV)、丙型肝炎病毒 (HCV) 和乙型肝炎病毒 (HBV) 是终末期肾病 (ESKD) 患者群体中常见的慢性病毒感染，这些病毒曾被认为是肾移植的相对禁忌症。在这篇综述中，我们将总结 HIV、HCV 和 HBV 患者肾移植的现状，这一现状正在迅速发展。在现代移植时代，HIV+ 患者的预后良好，并且随着 HIV+ 供体的使用，他们可能会有新的移植机会。直接作用抗病毒药物 (DAAs) 已极大地改变了 HCV 感染患者的治疗格局。HBV+ 患者现在通过 HBV 治疗可以获得极好的患者和移植物存活率。目前，对于大多数 HIV、HCV 和 HBV 感染的 ESKD 患者来说，肾移植是一种安全且合适的治疗方法。
