Sexual acquisition of HIV infection after solid organ transplantation: Late presentation and potentially fatal complications.
Transpl Infect Dis
; 20(4): e12894, 2018 Aug.
Article
em En
| MEDLINE
| ID: mdl-29603514
ABSTRACT
INTRODUCTION:
While the growing knowledge on HIV among solid organ transplant recipients (SOT) is limited to either pretransplant infection or allograft transmission, there are only sparse reports describing HIV-infection after transplantation through sexual route, the primary mode of transmission in the general population.METHODS:
From two different centers, we report nine new cases of HIV infection in SOT recipients attributed to sexual acquisition eight cases of kidney-transplant recipients and one heart-transplant recipient.FINDINGS:
There were nine cases of post-transplant HIV-infection detected among 14 526 transplants performed 1998 to 2015. In 6/9 cases, infection was contracted 5 years after SOT. All but one patient had stable allograft function under immunosuppressive therapy. The main trigger to diagnosis was late CMV disease and sexually transmitted diseases; five patients had CDC-stage 3 HIV infection. In 7/9 patients, virologic response and CD4 recovery were achieved within 3 months after starting antiretroviral therapy (ART). After an average of 3.6 years post diagnosis, 5/9 patients remained alive with well-controlled infection and functioning allograft.CONCLUSION:
Sexual acquisition of HIV infection after SOT represents a difficult challenge, as it may occur in any kind of transplant and at any time. The course of infection resembles that of the general population, with life-threatening infectious complications, but good response to ART. Assessment of lifestyle and risk behavior is paramount, as indications may be not disclosed without direct questioning.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
/
Atos_sexuais
Base de dados:
MEDLINE
Assunto principal:
Antivirais
/
Complicações Pós-Operatórias
/
Infecções por HIV
/
Transplante de Coração
/
Transplante de Rim
Tipo de estudo:
Clinical_trials
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Transpl Infect Dis
Assunto da revista:
TRANSPLANTE
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Brasil