Survival of kidney transplantation in people living with HIV/AIDS: a systematic review and meta-analysis
File(s)
Published version
Author(s)
Leung, Ka Chun
Ng, Wincy Wing Sze
Ciofani, Jonathan
Kwok, Wendy
Type
Journal Article
Abstract
Background:
The 2013 HIV Organ Policy Equity (HOPE) Act expanded kidney transplantation eligibility for people with HIV/AIDS (PWH), marking a significant milestone and necessitating updated reviews on the outcomes of renal transplantations on PWH.
Objective:
To assess kidney transplantation outcomes in PWH, including patient and graft survival, graft rejection, and infection rates.
Method:
We conducted a systematic review of studies published between 1990 and 2023. Included studies reported on kidney transplantation outcomes in PWH, focusing on graft and patient survival, rejection, and infections and compared with HIV-negative kidney graft recipients.
Result:
Out of 743 studies, 49 prospective and retrospective studies were included, with data of 6174 PWHs analysed. At one year post-transplant, patient survival in PWH was high at 94% (95% CI: 92.83–94.97%), with a decrease to 83% beyond five years (95% CI: 76.50–87.64%). Graft survival exhibited similar trends. Graft rejection rates increased from 26% in one year to 39% over five years. There were no significant differences in short- to medium-term recipient survival rates between PWH and HIV-negative individuals.
Conclusion:
Kidney transplantation is a viable option for PWH, with short- to medium-term outcomes comparable to HIV-negative recipients. Future research should focus on optimizing long-term outcomes.
The 2013 HIV Organ Policy Equity (HOPE) Act expanded kidney transplantation eligibility for people with HIV/AIDS (PWH), marking a significant milestone and necessitating updated reviews on the outcomes of renal transplantations on PWH.
Objective:
To assess kidney transplantation outcomes in PWH, including patient and graft survival, graft rejection, and infection rates.
Method:
We conducted a systematic review of studies published between 1990 and 2023. Included studies reported on kidney transplantation outcomes in PWH, focusing on graft and patient survival, rejection, and infections and compared with HIV-negative kidney graft recipients.
Result:
Out of 743 studies, 49 prospective and retrospective studies were included, with data of 6174 PWHs analysed. At one year post-transplant, patient survival in PWH was high at 94% (95% CI: 92.83–94.97%), with a decrease to 83% beyond five years (95% CI: 76.50–87.64%). Graft survival exhibited similar trends. Graft rejection rates increased from 26% in one year to 39% over five years. There were no significant differences in short- to medium-term recipient survival rates between PWH and HIV-negative individuals.
Conclusion:
Kidney transplantation is a viable option for PWH, with short- to medium-term outcomes comparable to HIV-negative recipients. Future research should focus on optimizing long-term outcomes.
Date Issued
2025-09-26
Date Acceptance
2025-08-01
Citation
BMC Infectious Diseases, 2025, 25
ISSN
1471-2334
Publisher
BMC
Journal / Book Title
BMC Infectious Diseases
Volume
25
Copyright Statement
© The Author(s) 2025 This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
License URL
Identifier
10.1186/s12879-025-11480-7
Subjects
Kidney Transplantation
HIV/AIDS
Human Immunodeficiency Virus
Antiretroviral Therapy
People with HIV
Publication Status
Published
Article Number
ARTN 1160
Date Publish Online
2025-09-26