02357nas a2200241   4500008004500000022001400045245005600059210005500115260001200170300001600182490000700198520171700205653003401922653001001956653001701966100001401983700001201997700001402009700001502023700001702038700001602055856004402071       2010                        Engldsh    a0041-134500aCase Report: HIV Infection From a Kidney Transplant0 aCase Report HIV Infection From a Kidney Transplant  cJul-Aug  a2267 - 22690 v423 aThe transmission of human immunodeficiency virus (HIV) through transplantation of human tissues and organs is rare but not impossible. A 27-year-old Bulgarian woman received a kidney transplant from a cadaveric donor owing to chronic renal failure due to glomerulonephritis of unknown etiology. Five days after the donation, the tissues showed HIV-1 infection, so she was immediately initiated on highly active antiretroviral therapy (HAART) with lopinavir/ritonavir, zidovudine, enfuvirtide, and lamivudine. Subsequently, according to the genotypic test which revealed a complex resistance pattern of the HIV-1, we changed the regimen to darunavir/ritonavir, etravirine, lamivudine, and enfuvirtide. The HIV-1 genome (550 UI/mL), which was detected at 5 days after transplantation, rapidly declined to undetectable levels at 3 weeks after HAART. The CD4+ T-cell nadir was 432 cells/mu L (40%) to 1,400 cells/mu L after 2 years. The posttransplantation course was complicated by cytomegalovirus pneumonia. At 32 months after transplantation, the patient had experienced hypertension with secondary retinopathy, bilateral cataracts, diabetes, hypothyroidism, osteoporosis with multiple vertebral fractures, a hip prosthesis, and a bone infarction of the femur. Major management problems had been related to steroid and HAART treatment side effects. Therapeutic interactions between the immunosuppressants and the antiretroviral drugs were complex for management, requiring frequent checks of drug levels and dose-adjustments. We finally obtained a stable clinical and viroimmunologic condition. The transmission of multiresistant strains of HIV from unknown patients requires complex multidisciplinary management.10aactive antiretroviral therapy10aorgan10atransmission1 aBorchi, B1 aAmbu, S1 aBresci, S1 aZanazzi, M1 aSalvadori, M1 aLeoncini, F  uhttp://613633.bywedr.asia/reference/197