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?

A. Ritonavir

B. Efavirenz

C. Lamivudine

D. Abacavir

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?

A. Lower

B. Equal

C. Higher

D. Unknown

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.

To see answers, please click here.

To view the article abstract or full-text (subscription required), please visit AJKD.org.