The kidney as a reservoir for HIV-1 after renal transplantation. - Université Paris Cité Accéder directement au contenu
Article Dans Une Revue Journal of the American Society of Nephrology Année : 2014

The kidney as a reservoir for HIV-1 after renal transplantation.

Guillaume Canaud
  • Fonction : Auteur
Jean-Paul Viard
  • Fonction : Auteur
Dany Anglicheau
Frank Bienaimé
  • Fonction : Auteur
Mordi Muorah
  • Fonction : Auteur
Louise Galmiche
  • Fonction : Auteur
Laure-Helene Noël
  • Fonction : Auteur
Frank Martinez
  • Fonction : Auteur
Rebecca Sberro-Soussan
  • Fonction : Auteur
Anne Scemla
  • Fonction : Auteur
Marie-Claire Gubler
  • Fonction : Auteur
Gérard Friedlander
  • Fonction : Auteur
Andrea Onetti Muda
  • Fonction : Auteur
Fabiola Terzi
  • Fonction : Auteur
Christophe Legendre
  • Fonction : Auteur

Résumé

Since the recent publication of data showing favorable outcomes for patients with HIV-1 and ESRD, kidney transplantation has become a therapeutic option in this population. However, reports have documented unexplained reduced allograft survival in these patients. We hypothesized that the unrecognized infection of the transplanted kidney by HIV-1 can compromise long-term allograft function. Using electron microscopy and molecular biology, we examined protocol renal transplant biopsies from 19 recipients with HIV-1 who did not have detectable levels of plasma HIV-1 RNA at transplantation. We found that HIV-1 infected the kidney allograft in 68% of these patients. Notably, HIV-1 infection was detected in either podocytes predominately (38% of recipients) or tubular cells only (62% of recipients). Podocyte infection associated with podocyte apoptosis and loss of differentiation markers as well as a faster decline in allograft function compared with tubular cell infection. In allografts with tubular cell infection, epithelial cells of the proximal convoluted tubules frequently contained abnormal mitochondria, and both patients who developed features of subclinical acute cellular rejection had allografts with tubular cell infection. Finally, we provide a novel noninvasive test for determining HIV-1 infection of the kidney allograft by measuring HIV-1 DNA and RNA levels in patients' urine. In conclusion, HIV-1 can infect kidney allografts after transplantation despite undetectable viremia, and this infection might influence graft outcome.

Dates et versions

hal-01121764 , version 1 (02-03-2015)

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Citer

Guillaume Canaud, Nathalie Dejucq-Rainsford, Véronique Avettand-Fenoël, Jean-Paul Viard, Dany Anglicheau, et al.. The kidney as a reservoir for HIV-1 after renal transplantation.. Journal of the American Society of Nephrology, 2014, 25 (2), pp.407-19. ⟨10.1681/ASN.2013050564⟩. ⟨hal-01121764⟩
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