Low incidence of acute rejection within 6 months of kidney transplantation in HIV‐infected recipients treated with raltegravir: the Agence Nationale de Recherche sur le Sida et les Hépatites Virales (ANRS) 153 TREVE trial

Autor: M, Matignon, J-D, Lelièvre, A, Lahiani, K, Abbassi, D, Desvaux, A, Diallo, M-N, Peraldi, A-M, Taburet, J, Saillard, C, Delaugerre, D, Costagliola, L, Assoumou, P, Grimbert, François, Dabis
Přispěvatelé: Department of Cancer Services and Clinical Oncology, Charing Cross Hospital, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Sorbonne Université (SU), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10, Unité de la recherche fondamentale et clinique sur l' hépatite virale, France Recherche Nord & Sud Asdi-VIH Hépatites, Agence Nationale de Recherche sur le Sida, Agence Nationale de Recherches sur le Sida et les Hépatites Virales (ANRS), Service de Néphrologie [Saint-Louis], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)
Rok vydání: 2019
Předmět:
Adult
Graft Rejection
Male
0301 basic medicine
medicine.medical_specialty
Anti-HIV Agents
kidney transplantation
HIV Infections
03 medical and health sciences
0302 clinical medicine
[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases
Raltegravir Potassium
Internal medicine
end-stage kidney disease
medicine
Humans
Pharmacology (medical)
Prospective Studies
030212 general & internal medicine
Sida
Kidney transplantation
biology
business.industry
Incidence
Health Policy
Incidence (epidemiology)
HIV
Middle Aged
Viral Load
medicine.disease
Raltegravir
biology.organism_classification
[SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology
030112 virology
3. Good health
Transplantation
Regimen
[SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology
Infectious Diseases
HIV-associated nephropathy
[SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology
HIV-1
Female
raltegravir
business
Viral load
[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
medicine.drug
Zdroj: HIV Medicine
HIV Medicine, Wiley, 2019, 20 (3), pp.202-213. ⟨10.1111/hiv.12700⟩
ISSN: 1468-1293
1464-2662
DOI: 10.1111/hiv.12700
Popis: International audience; Objectives: High rates of clinical acute rejection after kidney transplantation have been reported in people living with HIV (PLHIV), probably as a consequence of drug interactions. We therefore investigated the incidence of acute rejection within 6 months of transplantation in HIV-infected recipients treated with a protease-inhibitor-free raltegravir-based regimen.Methods: The Agence Nationale de Recherche sur le Sida et les Hépatites Virales (ANRS) 153 TREVE (NCT01453192) study was a prospective multicentre single-arm trial in adult PLHIV awaiting kidney transplantation, with viral load < 50 HIV-1 RNA copies/mL, CD4 T-cell count > 200 cells/μL, and HIV-1 strains sensitive to raltegravir, aiming to demonstrate 6-month clinical acute rejection rates < 30%. Time to transplantation was compared with that for uninfected subjects matched for age, sex and registration date.Results: In total, 61 participants were enrolled in the study, and 26 underwent kidney transplantation. Two participants experienced clinical acute rejection, corresponding to an estimated clinical acute rejection rate of 8% [95% confidence interval (CI) 2-24%] at 6 and 12 months post-transplantation. HIV infection remained under control in all but one participant, who temporarily stopped antiretroviral treatment. Median time to transplantation was longer in PLHIV than in controls (4.3 versus 2.8 years, respectively; P = 0.002) and was not influenced by blood group.Conclusions: Acute rejection rates were low after kidney transplantation in PLHIV treated with a raltegravir-based regimen. However, PLHIV have poorer access to transplantation than HIV-uninfected individuals after registration on the waiting list.
Databáze: OpenAIRE
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