Literature DB >> 20436737

Kidney transplantation in a patient with HIV disease.

L I Gonzalez-Granado1.   

Abstract

Entities:  

Year:  2009        PMID: 20436737      PMCID: PMC2859481          DOI: 10.4103/0971-4065.57113

Source DB:  PubMed          Journal:  Indian J Nephrol        ISSN: 0971-4065


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Sir, I have read with great interest the article from Bansai et al.[1] I agree that we are now able to offer good alternatives to HIV patients transplanting kidney or liver apart from conservative management. However, I disagree with the antiretroviral regimen. It is well known that new PI's are preferable than old ones and nevirapine.[2] The only point is that you need to check serum antiretroviral levels at least for several weeks after kidney transplantation in order to achieve a suitable dose and dose interval. For instance, with lopinavir/ritonavir (LPV/r), frequently a more prolonged interval of dose and dose lowering is needed. Today, nevirapine is used only in children below 6 months of age, women with CD4 count below 250 cells/mm3 and men with less than 400 cells/mm3. With higher CD4 count, severe hepatotoxicity has been described. In some cases, hepatic injuries continued to progress despite discontinuation of nevirapine.[3] International guidelines do not recommend the regimen for this patient.[45] I would like to emphasize that serum levels of antiretroviral drugs may help to achieve the best outcome for kidney transplantation in HIV patients.
  4 in total

Review 1.  Hepatotoxicity associated with nevirapine use.

Authors:  Melisse Sloas Baylor; Rosemary Johann-Liang
Journal:  J Acquir Immune Defic Syndr       Date:  2004-04-15       Impact factor: 3.731

2.  Guidelines for the use of antiretroviral agents in HIV-infected adults and adolescents, January 28, 2000 by the Panel on Clinical Practices for Treatment of HIV Infection.

Authors: 
Journal:  HIV Clin Trials       Date:  2000 Jul-Aug

3.  Initiating highly active antiretroviral therapy with newer protease inhibitors is associated with better survival compared to first-generation protease inhibitors or nevirapine.

Authors:  Heidi M Crane; Stephen E Van Rompaey; Mari M Kitahata
Journal:  AIDS Patient Care STDS       Date:  2007-12       Impact factor: 5.078

4.  Kidney transplantation in a patient with HIV disease.

Authors:  S B Bansal; M Singhal; R Ahlawat; V Kher
Journal:  Indian J Nephrol       Date:  2009-04
  4 in total
  1 in total

1.  Reply to 'kidney transplantation in a patient with HIV disease'.

Authors:  S B Bansal; M Singhal; R Ahlawat; V Kher
Journal:  Indian J Nephrol       Date:  2009-10
  1 in total

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