National Landscape of Human Immunodeficiency Virus-Positive Deceased Organ Donors in the United States
© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissionsoup.com..
BACKGROUND: Organ transplantation from donors with human immunodeficiency virus (HIV) to recipients with HIV (HIV D+/R+) presents risks of donor-derived infections. Understanding clinical, immunologic, and virologic characteristics of HIV-positive donors is critical for safety.
METHODS: We performed a prospective study of donors with HIV-positive and HIV false-positive (FP) test results within the HIV Organ Policy Equity (HOPE) Act in Action studies of HIV D+/R+ transplantation (ClinicalTrials.gov NCT02602262, NCT03500315, and NCT03734393). We compared clinical characteristics in HIV-positive versus FP donors. We measured CD4 T cells, HIV viral load (VL), drug resistance mutations (DRMs), coreceptor tropism, and serum antiretroviral therapy (ART) detection, using mass spectrometry in HIV-positive donors.
RESULTS: Between March 2016 and March 2020, 92 donors (58 HIV positive, 34 FP), representing 98.9% of all US HOPE donors during this period, donated 177 organs (131 kidneys and 46 livers). Each year the number of donors increased. The prevalence of hepatitis B (16% vs 0%), syphilis (16% vs 0%), and cytomegalovirus (CMV; 91% vs 58%) was higher in HIV-positive versus FP donors; the prevalences of hepatitis C viremia were similar (2% vs 6%). Most HIV-positive donors (71%) had a known HIV diagnosis, of whom 90% were prescribed ART and 68% had a VL <400 copies/mL. The median CD4 T-cell count (interquartile range) was 194/µL (77-331/µL), and the median CD4 T-cell percentage was 27.0% (16.8%-36.1%). Major HIV DRMs were detected in 42%, including nonnucleoside reverse-transcriptase inhibitors (33%), integrase strand transfer inhibitors (4%), and multiclass (13%). Serum ART was detected in 46% and matched ART by history.
CONCLUSION: The use of HIV-positive donor organs is increasing. HIV DRMs are common, yet resistance that would compromise integrase strand transfer inhibitor-based regimens is rare, which is reassuring regarding safety.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2022 |
|---|---|
| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:74 |
|---|---|
| Enthalten in: |
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America - 74(2022), 11 vom: 10. Juni, Seite 2010-2019 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Werbel, William A [VerfasserIn] |
|---|
| Links: |
|---|
| Anmerkungen: |
Date Completed 14.06.2022 Date Revised 25.03.2023 published: Print ClinicalTrials.gov: NCT03500315, NCT03734393, NCT02602262 Citation Status MEDLINE |
|---|
| doi: |
10.1093/cid/ciab743 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM329963562 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM329963562 | ||
| 003 | DE-627 | ||
| 005 | 20231225210250.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2022 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1093/cid/ciab743 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1099.xml |
| 035 | |a (DE-627)NLM329963562 | ||
| 035 | |a (NLM)34453519 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Werbel, William A |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a National Landscape of Human Immunodeficiency Virus-Positive Deceased Organ Donors in the United States |
| 264 | 1 | |c 2022 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 14.06.2022 | ||
| 500 | |a Date Revised 25.03.2023 | ||
| 500 | |a published: Print | ||
| 500 | |a ClinicalTrials.gov: NCT03500315, NCT03734393, NCT02602262 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissionsoup.com. | ||
| 520 | |a BACKGROUND: Organ transplantation from donors with human immunodeficiency virus (HIV) to recipients with HIV (HIV D+/R+) presents risks of donor-derived infections. Understanding clinical, immunologic, and virologic characteristics of HIV-positive donors is critical for safety | ||
| 520 | |a METHODS: We performed a prospective study of donors with HIV-positive and HIV false-positive (FP) test results within the HIV Organ Policy Equity (HOPE) Act in Action studies of HIV D+/R+ transplantation (ClinicalTrials.gov NCT02602262, NCT03500315, and NCT03734393). We compared clinical characteristics in HIV-positive versus FP donors. We measured CD4 T cells, HIV viral load (VL), drug resistance mutations (DRMs), coreceptor tropism, and serum antiretroviral therapy (ART) detection, using mass spectrometry in HIV-positive donors | ||
| 520 | |a RESULTS: Between March 2016 and March 2020, 92 donors (58 HIV positive, 34 FP), representing 98.9% of all US HOPE donors during this period, donated 177 organs (131 kidneys and 46 livers). Each year the number of donors increased. The prevalence of hepatitis B (16% vs 0%), syphilis (16% vs 0%), and cytomegalovirus (CMV; 91% vs 58%) was higher in HIV-positive versus FP donors; the prevalences of hepatitis C viremia were similar (2% vs 6%). Most HIV-positive donors (71%) had a known HIV diagnosis, of whom 90% were prescribed ART and 68% had a VL <400 copies/mL. The median CD4 T-cell count (interquartile range) was 194/µL (77-331/µL), and the median CD4 T-cell percentage was 27.0% (16.8%-36.1%). Major HIV DRMs were detected in 42%, including nonnucleoside reverse-transcriptase inhibitors (33%), integrase strand transfer inhibitors (4%), and multiclass (13%). Serum ART was detected in 46% and matched ART by history | ||
| 520 | |a CONCLUSION: The use of HIV-positive donor organs is increasing. HIV DRMs are common, yet resistance that would compromise integrase strand transfer inhibitor-based regimens is rare, which is reassuring regarding safety | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, N.I.H., Intramural | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
| 650 | 4 | |a HIV | |
| 650 | 4 | |a drug resistance | |
| 650 | 4 | |a organ donation | |
| 650 | 4 | |a transplant | |
| 650 | 7 | |a Anti-Retroviral Agents |2 NLM | |
| 650 | 7 | |a Integrases |2 NLM | |
| 650 | 7 | |a EC 2.7.7.- |2 NLM | |
| 700 | 1 | |a Brown, Diane M |e verfasserin |4 aut | |
| 700 | 1 | |a Kusemiju, Oyinkansola T |e verfasserin |4 aut | |
| 700 | 1 | |a Doby, Brianna L |e verfasserin |4 aut | |
| 700 | 1 | |a Seaman, Shanti M |e verfasserin |4 aut | |
| 700 | 1 | |a Redd, Andrew D |e verfasserin |4 aut | |
| 700 | 1 | |a Eby, Yolanda |e verfasserin |4 aut | |
| 700 | 1 | |a Fernandez, Reinaldo E |e verfasserin |4 aut | |
| 700 | 1 | |a Desai, Niraj M |e verfasserin |4 aut | |
| 700 | 1 | |a Miller, Jernelle |e verfasserin |4 aut | |
| 700 | 1 | |a Bismut, Gilad A |e verfasserin |4 aut | |
| 700 | 1 | |a Kirby, Charles S |e verfasserin |4 aut | |
| 700 | 1 | |a Schmidt, Haley A |e verfasserin |4 aut | |
| 700 | 1 | |a Clarke, William A |e verfasserin |4 aut | |
| 700 | 1 | |a Seisa, Michael |e verfasserin |4 aut | |
| 700 | 1 | |a Petropoulos, Christos J |e verfasserin |4 aut | |
| 700 | 1 | |a Quinn, Thomas C |e verfasserin |4 aut | |
| 700 | 1 | |a Florman, Sander S |e verfasserin |4 aut | |
| 700 | 1 | |a Huprikar, Shirish |e verfasserin |4 aut | |
| 700 | 1 | |a Rana, Meenakshi M |e verfasserin |4 aut | |
| 700 | 1 | |a Friedman-Moraco, Rachel J |e verfasserin |4 aut | |
| 700 | 1 | |a Mehta, Aneesh K |e verfasserin |4 aut | |
| 700 | 1 | |a Stock, Peter G |e verfasserin |4 aut | |
| 700 | 1 | |a Price, Jennifer C |e verfasserin |4 aut | |
| 700 | 1 | |a Stosor, Valentina |e verfasserin |4 aut | |
| 700 | 1 | |a Mehta, Shikha G |e verfasserin |4 aut | |
| 700 | 1 | |a Gilbert, Alexander J |e verfasserin |4 aut | |
| 700 | 1 | |a Elias, Nahel |e verfasserin |4 aut | |
| 700 | 1 | |a Morris, Michele I |e verfasserin |4 aut | |
| 700 | 1 | |a Mehta, Sapna A |e verfasserin |4 aut | |
| 700 | 1 | |a Small, Catherine B |e verfasserin |4 aut | |
| 700 | 1 | |a Haidar, Ghady |e verfasserin |4 aut | |
| 700 | 1 | |a Malinis, Maricar |e verfasserin |4 aut | |
| 700 | 1 | |a Husson, Jennifer S |e verfasserin |4 aut | |
| 700 | 1 | |a Pereira, Marcus R |e verfasserin |4 aut | |
| 700 | 1 | |a Gupta, Gaurav |e verfasserin |4 aut | |
| 700 | 1 | |a Hand, Jonathan |e verfasserin |4 aut | |
| 700 | 1 | |a Kirchner, Varvara A |e verfasserin |4 aut | |
| 700 | 1 | |a Agarwal, Avinash |e verfasserin |4 aut | |
| 700 | 1 | |a Aslam, Saima |e verfasserin |4 aut | |
| 700 | 1 | |a Blumberg, Emily A |e verfasserin |4 aut | |
| 700 | 1 | |a Wolfe, Cameron R |e verfasserin |4 aut | |
| 700 | 1 | |a Myer, Kevin |e verfasserin |4 aut | |
| 700 | 1 | |a Wood, R Patrick |e verfasserin |4 aut | |
| 700 | 1 | |a Neidlinger, Nikole |e verfasserin |4 aut | |
| 700 | 1 | |a Strell, Sara |e verfasserin |4 aut | |
| 700 | 1 | |a Shuck, Marion |e verfasserin |4 aut | |
| 700 | 1 | |a Wilkins, Harry |e verfasserin |4 aut | |
| 700 | 1 | |a Wadsworth, Matthew |e verfasserin |4 aut | |
| 700 | 1 | |a Motter, Jennifer D |e verfasserin |4 aut | |
| 700 | 1 | |a Odim, Jonah |e verfasserin |4 aut | |
| 700 | 1 | |a Segev, Dorry L |e verfasserin |4 aut | |
| 700 | 1 | |a Durand, Christine M |e verfasserin |4 aut | |
| 700 | 1 | |a Tobian, Aaron A R |e verfasserin |4 aut | |
| 700 | 0 | |a HOPE in Action Investigators |e verfasserin |4 aut | |
| 700 | 1 | |a Piquant, Dominque |e investigator |4 oth | |
| 700 | 1 | |a Link, Katherine |e investigator |4 oth | |
| 700 | 1 | |a Hemmersbach-Miller, Marion |e investigator |4 oth | |
| 700 | 1 | |a Pearson, Thomas |e investigator |4 oth | |
| 700 | 1 | |a Turgeon, Nicole |e investigator |4 oth | |
| 700 | 1 | |a Lyon, G Marshall |e investigator |4 oth | |
| 700 | 1 | |a Kitchens, William |e investigator |4 oth | |
| 700 | 1 | |a Huckaby, Jeryl |e investigator |4 oth | |
| 700 | 1 | |a Lasseter, A Francie |e investigator |4 oth | |
| 700 | 1 | |a Elbein, Rivka |e investigator |4 oth | |
| 700 | 1 | |a Roberson, April |e investigator |4 oth | |
| 700 | 1 | |a Ferry, Elizabeth |e investigator |4 oth | |
| 700 | 1 | |a Klock, Ethan |e investigator |4 oth | |
| 700 | 1 | |a Cochran, Willa V |e investigator |4 oth | |
| 700 | 1 | |a Morrison, Michelle |e investigator |4 oth | |
| 700 | 1 | |a Rasmussen, Sarah |e investigator |4 oth | |
| 700 | 1 | |a Bollinger, Juli |e investigator |4 oth | |
| 700 | 1 | |a Sugarman, Jeremy |e investigator |4 oth | |
| 700 | 1 | |a Smith, Angela R |e investigator |4 oth | |
| 700 | 1 | |a Thomas, Margaret |e investigator |4 oth | |
| 700 | 1 | |a Coakley, Margaret |e investigator |4 oth | |
| 700 | 1 | |a Timpone, Joseph |e investigator |4 oth | |
| 700 | 1 | |a Stucke, Alyssa |e investigator |4 oth | |
| 700 | 1 | |a Haydel, Brandy |e investigator |4 oth | |
| 700 | 1 | |a Dieter, Rebecca |e investigator |4 oth | |
| 700 | 1 | |a Klein, Elizabeth J |e investigator |4 oth | |
| 700 | 1 | |a Neumann, Henry |e investigator |4 oth | |
| 700 | 1 | |a Gallon, Lorenzo |e investigator |4 oth | |
| 700 | 1 | |a Goudy, Leah |e investigator |4 oth | |
| 700 | 1 | |a Callegari, Michelle |e investigator |4 oth | |
| 700 | 1 | |a Marrazzo, Ilise |e investigator |4 oth | |
| 700 | 1 | |a Jackson, Towanda |e investigator |4 oth | |
| 700 | 1 | |a Pruett, Timothy |e investigator |4 oth | |
| 700 | 1 | |a Farnsworth, Mary |e investigator |4 oth | |
| 700 | 1 | |a Locke, Jayme E |e investigator |4 oth | |
| 700 | 1 | |a Mompoint-Williams, Darnell |e investigator |4 oth | |
| 700 | 1 | |a Basinger, Katherine |e investigator |4 oth | |
| 700 | 1 | |a Mekeel, Kristin |e investigator |4 oth | |
| 700 | 1 | |a Nguyen, Phirum |e investigator |4 oth | |
| 700 | 1 | |a Kwan, Joanne |e investigator |4 oth | |
| 700 | 1 | |a Srisengfa, Tab |e investigator |4 oth | |
| 700 | 1 | |a Chin-Hong, Peter |e investigator |4 oth | |
| 700 | 1 | |a Rogers, Rodney |e investigator |4 oth | |
| 700 | 1 | |a Simkins, Jacques |e investigator |4 oth | |
| 700 | 1 | |a Munoz, Carlos |e investigator |4 oth | |
| 700 | 1 | |a Dunn, Ty |e investigator |4 oth | |
| 700 | 1 | |a Sawinski, Dierdre |e investigator |4 oth | |
| 700 | 1 | |a Silveira, Fernanda |e investigator |4 oth | |
| 700 | 1 | |a Hughes, Kailey |e investigator |4 oth | |
| 700 | 1 | |a Pakstis, Diana Lynn |e investigator |4 oth | |
| 700 | 1 | |a Nagy, Jamie |e investigator |4 oth | |
| 700 | 1 | |a Baldecchi, Mary |e investigator |4 oth | |
| 700 | 1 | |a Muthukumar, Thangamani |e investigator |4 oth | |
| 700 | 1 | |a Eddie, Melissa D |e investigator |4 oth | |
| 700 | 1 | |a Robb, Katharine |e investigator |4 oth | |
| 700 | 1 | |a Salsgiver, Elizabeth |e investigator |4 oth | |
| 700 | 1 | |a Witting, Britta |e investigator |4 oth | |
| 700 | 1 | |a Azar, Marwan M |e investigator |4 oth | |
| 700 | 1 | |a Villanueva, Merceditas |e investigator |4 oth | |
| 700 | 1 | |a Formica, Richard |e investigator |4 oth | |
| 700 | 1 | |a Tomlin, Ricarda |e investigator |4 oth | |
| 773 | 0 | 8 | |i Enthalten in |t Clinical infectious diseases : an official publication of the Infectious Diseases Society of America |d 1992 |g 74(2022), 11 vom: 10. Juni, Seite 2010-2019 |w (DE-627)NLM012603007 |x 1537-6591 |7 nnns |
| 773 | 1 | 8 | |g volume:74 |g year:2022 |g number:11 |g day:10 |g month:06 |g pages:2010-2019 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1093/cid/ciab743 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 74 |j 2022 |e 11 |b 10 |c 06 |h 2010-2019 | ||