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Access to the waiting list and to kidney transplantation for people living with HIV: A national registry study

American journal of transplantation, 2019-12, Vol.19 (12), p.3345-3355 [Peer Reviewed Journal]

2019 The American Society of Transplantation and the American Society of Transplant Surgeons ;2019 The American Society of Transplantation and the American Society of Transplant Surgeons. ;Distributed under a Creative Commons Attribution 4.0 International License ;ISSN: 1600-6135 ;EISSN: 1600-6143 ;DOI: 10.1111/ajt.15500 ;PMID: 31206243

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Title:
Access to the waiting list and to kidney transplantation for people living with HIV: A national registry study
Author: Tourret, Jérôme ; Guiguet, Marguerite ; Lassalle, Mathilde ; Grabar, Sophie ; Lièvre, Laurence ; Isnard‐Bagnis, Corinne ; Barrou, Benoit ; Costagliola, Dominique ; Couchoud, Cécile ; Abgrall, Sophie ; Tézenas Du Montcel, Sophie
Subjects: Access to Information ; Adult ; Antiretroviral drugs ; Antiretroviral therapy ; clinical research/practice ; Cohort Studies ; Diabetes mellitus ; Dialysis ; end‐stage renal disease ; Epidemiology ; Female ; Follow-Up Studies ; Health Services Accessibility - standards ; Health Services Accessibility - statistics & numerical data ; Healthcare Disparities - standards ; Healthcare Disparities - statistics & numerical data ; Hemodialysis ; HIV ; HIV - isolation & purification ; HIV infection ; HIV Infections - complications ; Human health and pathology ; Human immunodeficiency virus ; Humans ; infection and infectious agents ‐ viral: human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) ; infectious disease ; Kidney Failure, Chronic - surgery ; Kidney transplantation ; Kidney Transplantation - statistics & numerical data ; kidney transplantation/nephrology ; Kidneys ; Life Sciences ; Male ; Middle Aged ; Nephropathy ; organ allocation ; organ procurement and allocation ; panel reactive antibody (PRA) ; Prognosis ; Registries ; Renal Dialysis ; renal replacement therapy ; Surgery ; Survival Rate ; Transplants & implants ; Urology and Nephrology ; waiting list ; Waiting Lists - mortality
Is Part Of: American journal of transplantation, 2019-12, Vol.19 (12), p.3345-3355
Description: We compared access to a kidney transplantation (KT) waiting list (WL) and to KT between people living with HIV (PLHIV) and HIV‐uninfected controls. Using the REIN (the national Renal Epidemiology and Information Network registry), we included all PLHIV initiating dialysis in France throughout 2006‐2010 and HIV‐uninfected controls matched for age, sex, year of dialysis initiation, and the existence of a diabetic nephropathy. Patients were prospectively followed until December 2015. We used a competitive risk approach to assess the cumulative incidence of enrollment on WL and of KT, with death as a competing event (subdistribution hazard ratio adjusted on comorbidities, asdHR). There were 255 PLHIV in the REIN (median age 47 years) of whom 180 (71%) were also found in the French Hospital Database on HIV (FHDH‐ANRS CO4) including 126 (70%) known to be on antiretroviral therapy with HIV viral suppression (VS). Five years after dialysis initiation, 65%, and 76%, of treated PLHIV with VS, and of HIV‐uninfected controls were enrolled on a WL (asdHR 0.68; 95% CI 0.50‐0.91). Access to KT was also less frequent and delayed for treated PLHIV with VS (asdHR 0.75, 95% CI, 0.52‐1.10). PLHIV continue to face difficulties to access KT. Using a national cohort of all patients living with HIV in France, the authors show that those patients' access to a kidney transplantation list and subsequently to kidney transplantation is delayed and less frequent compared to HIV‐uninfected controls matched for age, sex, year of dialysis initiation, and the existence of a diabetic nephropathy.
Publisher: United States: Wiley Subscription Services, Inc
Language: English;French
Identifier: ISSN: 1600-6135
EISSN: 1600-6143
DOI: 10.1111/ajt.15500
PMID: 31206243
Source: Hyper Article en Ligne (HAL) (Open Access)
GFMER Free Medical Journals
MEDLINE

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Access to the waiting list and to kidney transplantation for people living with HIV: A national registry study

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