HealthDay News — Immunosuppressant therapy taken following kidney transplantation may help reduce persistent HIV burdens in infected patients, study findings indicate.
Among 91 kidney transplant recipients with HIV, lower post-transplant HIV DNA levels were associated with exposure to sirolimus (P=0.04), an immunosuppressant drug given to transplant patients to prevent organ rejection, Peter G. Stock, MD, PhD, from University of California San Francisco, and colleagues reported in the American Journal of Transplantation.
“Our study highlights the potential synergies that can occur when two very different disciplines merge their talents and resources,” a study coauthor said in a statement. “We feel that the transplant community has much to teach the HIV community about the potential role of strong immune-suppressing drugs in curing HIV disease.”
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The researchers analyzed stored plasma and peripheral blood mononuclear cell samples taken prior to transplantation and at weeks 12, 26, 52 and 104 post-transplant to study the impact of immunosuppressant therapy on peripheral blood measures of HIV persistence following kidney transplantation.
In addition to sirolimus exposure, lower posttransplant HIV DNA levels were associated with higher CD4+ T-cell count (P=0.001) and a longer duration of follow-up (P=0.06).
Higher HIV DNA levels posttransplant were significantly associated with a higher baseline HIV DNA (P<0.0001), whereas higher post-transplant plasma HIV RNA levels were associated with higher pre-transplant plasma HIV RNA levels (P<0.0001) and a longer duration of follow-up post-transplant (P=0.09).
“The association between sirolimus exposure and lower frequency of cells containing HIV DNA levels posttransplant suggest that the immune-modifying drugs may affect the level of HIV persistence during effect therapy,” the researchers wrote. “Future studies of sirolimus as a reservoir-modifying agent are warranted.”
