Human immunodeficiency virus infection in patients with solid-organ transplants: report of five cases and review

Abstract

Five recipients of solid-organ transplants who were infected with human immunodeficiency virus (HIV) were studied at the University of Minnesota, and our data were compared with data from 83 reported cases of HIV-infected recipients of solid organs from other centers. Sixty-six of the 88 patients were seronegative for HIV before transplantation and received organs or transfusions of blood from individuals who were seropositive for HIV. Seven patients (four recipients of kidney transplants and three recipients of liver transplants) received transplants after routine screening for HIV. Twenty-five (28%) of the 88 patients developed AIDS, and 20 (80%) of these 25 patients died of AIDS-related complications a mean of 37 months after transplantation. Another nine patients (10%) had other HIV-related diseases. The mean time of progression to AIDS was 27.5 months among all patients with AIDS. For patients who were seronegative for HIV at the time of transplantation, the mean time of progression to AIDS was 32 months, whereas patients seropositive before transplantation developed AIDS within 17 months. Shortly after transplantation, eleven (17%) of the patients who were initially seronegative experienced a febrile syndrome attributed to HIV. Ten patients, including eight recipients of kidney transplants and two recipients of liver transplants, maintained normal allograft function despite low-dose immunosuppressive therapy.