A recent article by Chandran et al published in the American Journal of Kidney Diseases describes a case of recurrent HIV-associated immune complex disease with lupus-like features following kidney transplantation. The following questions will test your knowledge on kidney transplantation and HIV-related kidney disease:
1. Finding the appropriate dose of calcineurin inhibitors (CNI) in a HIV-infected kidney transplant recipient on combination antiretroviral therapy can be difficult. Which of the following medications have pharmacologic interactions with cyclosporine and tacrolimus?
E. A&B only
F. All of the above
2. True or False: Successful control of HIV viral replication (i.e., “undetectable” viral load) always prevents HIV-mediated immunologic injury in the transplanted kidney.
3. Compared to non-infected individuals who receive kidney transplants, what are the rates of acute rejection in HIV-infected kidney transplant recipients?
4. Deliberate transplantation of kidneys from HIV-positive donors to HIV-infected recipients:
A. Has never been documented and is only theoretically possible
B. Has been performed in 1% of US transplant centers
C. Has resulted in accelerated HIV infection and virus mutation
D. Has been explored as a possible option in HIV endemic areas
Post prepared by Dr. Kellie Calderon, eAJKD Advisory Board member, Hofstra NSLIJ School of Medicine.
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