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Access to the waiting list and to kidney transplantation for people living with HIV: A national registry study
Author(s) -
Tourret Jérôme,
Guiguet Marguerite,
Lassalle Mathilde,
Grabar Sophie,
Lièvre Laurence,
IsnardBagnis Corinne,
Barrou Benoit,
Costagliola Dominique,
Couchoud Cécile,
Abgrall Sophie,
Tézenas Du Montcel Sophie
Publication year - 2019
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/ajt.15500
Subject(s) - medicine , dialysis , kidney transplantation , transplantation , cumulative incidence , epidemiology , hazard ratio , incidence (geometry) , confidence interval , physics , optics
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.