Send to

Choose Destination
Clin Transplant. 2019 May;33(5):e13532. doi: 10.1111/ctr.13532. Epub 2019 Apr 4.

Clinical outcomes in HIV+/HCV+ coinfected kidney transplant recipients in the pre- and post-direct-acting antiviral therapy eras: 10-Year single center experience.

Author information

Division of Infectious Disease, Department of Medicine, University of Miami Miller School of Medicine Miami, Florida.
Pharmacy Department, Jackson Memorial Hospital, Miami, Florida.
Department of Surgery, University of Miami Miller School of Medicine, and Miami Transplant Institute, Miami, Florida.
Division of Nephrology, Department of Medicine, University of Miami Miller School of Medicine Miami, Florida.
Division of Hepatology, Department of Medicine, University of Miami Miller School of Medicine Miami, Florida.



Previous studies have demonstrated inferior patient and graft survival following kidney transplant (KT) in HIV+/HCV+ coinfected patients compared to HIV+/HCV- recipients. However, these studies were conducted prior to the availability of direct-acting antiviral (DAA) agents and data in the modern era are lacking.


Single center retrospective study of HIV+/HCV+ coinfected KT recipients (2007-2017). Outcomes were assessed for the pre-DAA and post-DAA (ie, after December 2013) eras including 1-year patient survival, death-censored graft survival, and acute rejection; and serious infections (defined as infections requiring admission to the intensive care unit during initial transplant hospitalization or re-admission to the hospital after discharge) within the first 6 months post-transplant.


A total of 13 consecutive HIV+/HCV+ recipients were identified. Median time of post-transplant follow-up was 722 days. Seven patients were transplanted in the DAA era; five of them had anti-HCV Ab+ donors, with two donors being HCV NAT positive; all received DAA therapy, six of them post-transplant (median time from KT to DAA: 83 days; IQR, 54-300). All the patients in the pre-DAA era were on a protease inhibitor-containing ART regimen. One-year patient and death-censored graft survivals were 83% and 67%, respectively, for the patients transplanted in the pre-DAA era, and 100% for both outcomes in the subgroup of patients transplanted in the post-DAA era (P > 0.05). Compared to patients in the post-DAA era, those in the pre-DAA era had higher incidence of serious infections (0 vs 67%; P = 0.02). Acute rejection exclusively occurred in the pre-DAA group (n = 1; 17%).


Outcomes of HIV+/HCV+ KT recipients, including HIV-/HCV+ to HIV+/HCV+ transplants, in the DAA era were excellent in this small cohort. Larger studies are needed.


coinfection; direct-acting antivirals; hepatitis C virus; human immunodeficiency virus; kidney transplant


Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center