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National Landscape of Human Immunodeficiency Virus-Positive Deceased Organ Donors in the United States.
Werbel, William A; Brown, Diane M; Kusemiju, Oyinkansola T; Doby, Brianna L; Seaman, Shanti M; Redd, Andrew D; Eby, Yolanda; Fernandez, Reinaldo E; Desai, Niraj M; Miller, Jernelle; Bismut, Gilad A; Kirby, Charles S; Schmidt, Haley A; Clarke, William A; Seisa, Michael; Petropoulos, Christos J; Quinn, Thomas C; Florman, Sander S; Huprikar, Shirish; Rana, Meenakshi M; Friedman-Moraco, Rachel J; Mehta, Aneesh K; Stock, Peter G; Price, Jennifer C; Stosor, Valentina; Mehta, Shikha G; Gilbert, Alexander J; Elias, Nahel; Morris, Michele I; Mehta, Sapna A; Small, Catherine B; Haidar, Ghady; Malinis, Maricar; Husson, Jennifer S; Pereira, Marcus R; Gupta, Gaurav; Hand, Jonathan; Kirchner, Varvara A; Agarwal, Avinash; Aslam, Saima; Blumberg, Emily A; Wolfe, Cameron R; Myer, Kevin; Wood, R Patrick; Neidlinger, Nikole; Strell, Sara; Shuck, Marion; Wilkins, Harry; Wadsworth, Matthew; Motter, Jennifer D.
Afiliación
  • Werbel WA; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
  • Brown DM; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
  • Kusemiju OT; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
  • Doby BL; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
  • Seaman SM; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
  • Redd AD; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
  • Eby Y; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
  • Fernandez RE; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA.
  • Desai NM; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
  • Miller J; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
  • Bismut GA; Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
  • Kirby CS; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
  • Schmidt HA; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
  • Clarke WA; Department of Biochemistry, Cellular, and Molecular Biology, Johns Hopkins University, Baltimore, Maryland, USA.
  • Seisa M; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
  • Petropoulos CJ; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
  • Quinn TC; Laboratory Corporation of America (LabCorp), South San Francisco, California, USA.
  • Florman SS; Laboratory Corporation of America (LabCorp), South San Francisco, California, USA.
  • Huprikar S; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
  • Rana MM; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
  • Friedman-Moraco RJ; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA.
  • Mehta AK; Recanati/Miller Transplantation Institute, The Mount Sinai Hospital, New York City, New York, USA.
  • Stock PG; Department of Medicine, Division of Infectious Diseases, The Mount Sinai Hospital, New York City, New York, USA.
  • Price JC; Department of Medicine, Division of Infectious Diseases, The Mount Sinai Hospital, New York City, New York, USA.
  • Stosor V; Department of Medicine, Division of Infectious Diseases, Emory University, Atlanta, Georgia, USA.
  • Mehta SG; Department of Medicine, Division of Infectious Diseases, Emory University, Atlanta, Georgia, USA.
  • Gilbert AJ; Department of Surgery, University of California San Francisco, San Francisco, California, USA.
  • Elias N; Department of Medicine, University of California San Francisco, San Francisco, California, USA.
  • Morris MI; Division of Infectious Disease and Organ Transplantation, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
  • Mehta SA; Section of Transplant Nephrology, The University of Alabama at Birmingham, Birmingham, Alabama, USA.
  • Small CB; MedStar Georgetown Transplant Institute, Georgetown University School of Medicine, Washington, DC, USA.
  • Haidar G; Department of Surgery, Division of Transplant Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA.
  • Malinis M; Department of Medicine, Division of Infectious Diseases, University of Miami, Miami, Florida, USA.
  • Husson JS; New York University Langone Transplant Institute, New York University Grossman School of Medicine, New York, New York, USA.
  • Pereira MR; Department of Medicine, Division of Infectious Diseases, Weill Cornell Medical College, New York, New York, USA.
  • Gupta G; Department of Medicine, Division of Infectious Diseases, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
  • Hand J; Department of Medicine, Section of Infectious Diseases, Yale University School of Medicine, New Haven, Connecticut, USA.
  • Kirchner VA; Institute of Human Virology, University of Maryland School of Medicine, Baltimore, Maryland, USA.
  • Agarwal A; Department of Medicine, Division of Infectious Diseases, Columbia University Medical Center, New York, New York, USA.
  • Aslam S; Department of Medicine, Division of Nephrology, Virginia Commonwealth University, Richmond, Virginia, USA.
  • Blumberg EA; Department of Infectious Diseases, Ochsner Clinic Foundation, New Orleans, Louisiana, USA.
  • Wolfe CR; Department of Surgery, University of Minnesota, Minneapolis, Minnesota, USA.
  • Myer K; Department of Surgery, Division of Transplantation, University of Virginia, Charlottesville, Virginia, USA.
  • Wood RP; Department of Medicine, Division of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, California, USA.
  • Neidlinger N; Department of Medicine, Division of Infectious Diseases, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
  • Strell S; Department of Medicine, Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina, USA.
  • Shuck M; LifeGift, Houston, Texas, USA.
  • Wilkins H; Department of Surgery, Division of Transplantation, University of Wisconsin, Madison, Wisconsin, USA.
  • Wadsworth M; Department of Surgery, Division of Transplantation, University of Wisconsin, Madison, Wisconsin, USA.
  • Motter JD; UW Health Organ Procurement Organization, Madison, Wisconsin, USA.
Clin Infect Dis ; 74(11): 2010-2019, 2022 06 10.
Article en En | MEDLINE | ID: mdl-34453519
ABSTRACT

BACKGROUND:

Organ transplantation from donors with human immunodeficiency virus (HIV) to recipients with HIV (HIV D+/R+) presents risks of donor-derived infections. Understanding clinical, immunologic, and virologic characteristics of HIV-positive donors is critical for safety.

METHODS:

We performed a prospective study of donors with HIV-positive and HIV false-positive (FP) test results within the HIV Organ Policy Equity (HOPE) Act in Action studies of HIV D+/R+ transplantation (ClinicalTrials.gov NCT02602262, NCT03500315, and NCT03734393). We compared clinical characteristics in HIV-positive versus FP donors. We measured CD4 T cells, HIV viral load (VL), drug resistance mutations (DRMs), coreceptor tropism, and serum antiretroviral therapy (ART) detection, using mass spectrometry in HIV-positive donors.

RESULTS:

Between March 2016 and March 2020, 92 donors (58 HIV positive, 34 FP), representing 98.9% of all US HOPE donors during this period, donated 177 organs (131 kidneys and 46 livers). Each year the number of donors increased. The prevalence of hepatitis B (16% vs 0%), syphilis (16% vs 0%), and cytomegalovirus (CMV; 91% vs 58%) was higher in HIV-positive versus FP donors; the prevalences of hepatitis C viremia were similar (2% vs 6%). Most HIV-positive donors (71%) had a known HIV diagnosis, of whom 90% were prescribed ART and 68% had a VL <400 copies/mL. The median CD4 T-cell count (interquartile range) was 194/µL (77-331/µL), and the median CD4 T-cell percentage was 27.0% (16.8%-36.1%). Major HIV DRMs were detected in 42%, including nonnucleoside reverse-transcriptase inhibitors (33%), integrase strand transfer inhibitors (4%), and multiclass (13%). Serum ART was detected in 46% and matched ART by history.

CONCLUSION:

The use of HIV-positive donor organs is increasing. HIV DRMs are common, yet resistance that would compromise integrase strand transfer inhibitor-based regimens is rare, which is reassuring regarding safety.
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Texto completo: 1 Colección: 01-internacional Asunto principal: Infecciones por VIH / Seropositividad para VIH Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Humans País/Región como asunto: America do norte Idioma: En Revista: Clin Infect Dis Asunto de la revista: DOENCAS TRANSMISSIVEIS Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos
Texto completo
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XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Asunto principal: Infecciones por VIH / Seropositividad para VIH Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Humans País/Región como asunto: America do norte Idioma: En Revista: Clin Infect Dis Asunto de la revista: DOENCAS TRANSMISSIVEIS Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos