Leung Ka Chun, Ng Wincy Wing Sze, Ciofani Jonathan, Kwok Wendy
Department of Medicine and Geriatrics, Tuen Mun Hospital, Hong Kong Special Administrative Region, China.
Adult Intensive Care Unit, Queen Mary Hospital, Hong Kong Special Administrative Region, China.
BMC Infect Dis. 2025 Sep 26;25(1):1160. doi: 10.1186/s12879-025-11480-7.
The 2013 HIV Organ Policy Equity (HOPE) Act expanded kidney transplantation eligibility for people with HIV/AIDS (PWH), marking a significant milestone and necessitating updated reviews on the outcomes of renal transplantations on PWH.
To assess kidney transplantation outcomes in PWH, including patient and graft survival, graft rejection, and infection rates.
We conducted a systematic review of studies published between 1990 and 2023. Included studies reported on kidney transplantation outcomes in PWH, focusing on graft and patient survival, rejection, and infections and compared with HIV-negative kidney graft recipients.
Out of 743 studies, 49 prospective and retrospective studies were included, with data of 6174 PWHs analysed. At one year post-transplant, patient survival in PWH was high at 94% (95% CI: 92.83–94.97%), with a decrease to 83% beyond five years (95% CI: 76.50–87.64%). Graft survival exhibited similar trends. Graft rejection rates increased from 26% in one year to 39% over five years. There were no significant differences in short- to medium-term recipient survival rates between PWH and HIV-negative individuals.
Kidney transplantation is a viable option for PWH, with short- to medium-term outcomes comparable to HIV-negative recipients. Future research should focus on optimizing long-term outcomes.
The online version contains supplementary material available at 10.1186/s12879-025-11480-7.
2013年的《艾滋病毒器官政策公平性（HOPE）法案》扩大了艾滋病毒/艾滋病患者（PWH）的肾移植资格，这是一个重要的里程碑，因此有必要对PWH肾移植的结果进行更新评估。
评估PWH的肾移植结果，包括患者和移植物存活率、移植物排斥反应和感染率。
我们对1990年至2023年发表的研究进行了系统评价。纳入的研究报告了PWH的肾移植结果，重点关注移植物和患者的存活率、排斥反应和感染情况，并与艾滋病毒阴性的肾移植受者进行了比较。
在743项研究中，纳入了49项前瞻性和回顾性研究，分析了6174名PWH的数据。移植后一年，PWH的患者存活率较高，为94%（95%CI：92.83–94.97%），五年后降至83%（95%CI：76.50–87.64%）。移植物存活率呈现相似趋势。移植物排斥率从一年时的26%上升到五年时的39%。PWH和艾滋病毒阴性个体在短期至中期的受者存活率没有显著差异。
肾移植对PWH来说是一个可行的选择，其短期至中期结果与艾滋病毒阴性受者相当。未来的研究应侧重于优化长期结果。
在线版本包含可在10.1186/s12879-025-11480-7获取的补充材料。
