Overall, Segev said, "treatment of HIV-infected patients undergoing kidney transplantation is clearly not straightforward, and this study has identified some challenges for the transplant community to address."
On the bright side, transplant procedures didn't appear to have much of an impact on the HIV infections in the patients.
In years past, Norman said, transplant surgeons worried about how the AIDS virus would interact with the medications given to transplant patients that are designed to dampen the immune system. The concern was that "these patients are now doing well, and you're going to give them medicine and undo all their benefits," he said.
But it turns out that transplantation drugs have the opposite effect and often suppress the AIDS virus, he said. This is because HIV revs up the immune system while the drugs turn it down, he explained.
Norman said he expects that the new findings will encourage more surgeons to perform kidney transplants on HIV patients, who are frequently surviving long enough to develop diseases that typically target older people.
"There are still a lot of people in the community, including transplant professionals, nephrologists and infectious disease professionals, who still don't appreciate that many of these patients are good prospects for transplantation," Norman said. "They don't appreciate how many procedures have been done to date, and how we're getting overall very good outcomes."
For more about kidney transplants, try the U.S. National Library of Medicine.
SOURCES: Silas P. Norman, M.D., assistant professor, internal medicine, University of Michigan, Ann Arbor; Dorry Segev, M.D., Ph.D., associate professor, surgery and epidemiology, Johns Hopkins Medical Institutions, Baltimore; Nov. 18, 20
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