Non-Protease Inhibitor Regimen Recommended in HIV Kidney Transplants

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The authors linked IMS pharmacy fills with data from the Scientific Registry of Transplant Recipients.
The authors linked IMS pharmacy fills with data from the Scientific Registry of Transplant Recipients.

HealthDay News — For HIV-positive kidney transplantation (KT) recipients, outcomes are worse for those on a protease inhibitor (PI)-based vs non-PI-based antiretroviral therapy (ART) regimen, according to a study published online in the American Journal of Transplantation.

Deirdre Sawinski, MD, from the University of Pennsylvania Comprehensive Transplant Center in Philadelphia, and colleagues examined outcomes for HIV-positive KT recipients by ART regimen. The authors linked IMS pharmacy fills with data from the Scientific Registry of Transplant Recipients. A total of 332 KT recipients with pre- and post-transplant fills were classified according to PI or non-PI-based ART at the time of transplant (88 and 244 patients, respectively).

The researchers found that, compared with those on non-PI regimens, recipients on PI-based regimens were significantly more likely to have an estimated post-transplant score >20% (70.9% vs 56.3%). The risk of allograft loss was increased for PI-based regimens vs non-PI regimens (adjusted hazard ratio, 1.84), with the greatest risk seen in the first post-transplant year (adjusted hazard ratio, 4.48); increased risk of death was also seen for PI-based vs non-PI regimens (adjusted hazard ratio, 1.91).

"These results suggest whenever possible recipients should be converted to a non-PI regimen prior to KT," the authors write.

Reference

Sawinski D, Shelton BA, Mehta S, et al. Impact of protease inhibitor based anti-retroviral therapy on outcomes for HIV+ kidney transplant recipients [published online July 11, 2017]. Am J Transplant. doi:10.1111/ajt.14419

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