HIV positive patient gets a new lease of life with successful renal transplant
Over the past year, he developed chronic kidney disease and hypertension, necessitating hemodialysis since January 2024
A 38-year-old person from Bengaluru, who has been living with HIV for over five years, got a new lease of life following a renal transplant at a private hospital in the city.
The patient – Mahesh (name changed) – was diagnosed with Diabetes Mellitus ten years ago. In 2022, he successfully completed treatment for Pulmonary Kochs. Over the past year, he developed chronic kidney disease and hypertension, necessitating hemodialysis since January 2024. Following his HIV-positive status, he was put on antiretroviral treatment (ART). However, multiple hospitals had previously rejected him for renal transplantation.
He then visited SPARSH hospitals where he underwent a comprehensive workup for kidney transplantation. His father-in-law was identified as a suitable donor due to blood group compatibility. After ruling out opportunistic infections and confirming a CD4 count above 500, the doctors optimised his medication regimen to manage potential drug interactions. The transplant was performed with strict universal precautions, ensuring the safety of both patient and staff.
A team of doctors comprising Harsha Kumar H.N., Sunil R., Avinash T.S., Shashank M.S., and John Paul were involved in achieving this successful outcome. They emphasised the challenges of kidney transplantation in HIV-positive patients, including heightened risks of infection and rejection. However, with meticulous planning and advanced surgical skills, these risks were effectively managed.
“Our skilled team executed the procedure precisely, resulting in excellent graft function. He was discharged on the eighth postoperative day. This case highlights the commitment to providing advanced medical care and overcoming the challenges associated with complex health conditions,” said Dr. Kumar, Senior Consultant – Nephrology and Transplant Physician at the hospital.
“Performing a kidney transplant on an HIV-positive patient requires careful consideration and precise execution to manage the increased risk of infections and complications, HIV-positive patients on hemodialysis typically have a poor prognosis. However, the availability of highly active antiretroviral therapy (HAART), is a treatment regimen typically comprising a combination of three or more antiretroviral drugs, has extended their lifespan,” the doctor said.
Stating that many HIV patients develop nephropathy and end-stage renal disease, necessitating hemodialysis, Dr. Kumar said: “Now, with ART offering minimal drug interactions, HIV is no longer a risk factor for kidney transplants. The successful surgery showcases that HIV-positive patients can now be considered for renal transplantation with significantly improved survival prospects.”
Dr. Avinash, Consultant Urologist and Renal Transplant Surgeon at the hospital said that the case highlighted the advancements in HIV treatment and the importance of a multidisciplinary approach. “Our ability to manage drug interactions between antiretroviral and immunosuppressive therapies was crucial in ensuring the success of the transplant,” he added.
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