2019 Ryan White HIV/AIDS Program CLINICAL CONFERENCE

Standarddonorcriteriaplus positiveHIVELISAand/or NAT*

UndetectableHIV (RNA <200 c/mL)

Detectable HIV (RNA >200 c/mL)

ARTnaïve Nohistory of ART andundetectable drug levels

Virologic failure Prescribed ART and/or detectable drug levels

Lower riskof HIV superinfection and drug resistance

Higher riskof HIV superinfection and drug resistance

Higher riskdonor

Lower riskdonor

• First line ART regimen • R5 tropic virus • Potential for PI Ritonavir -sparing regimen • Higher CD4+ T cell count

• Second-line ART • X4 tropicvirus • Historyof drug resistance • Requires PI/Ritonavir-based regimen • Lower CD4+ T cell count

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Summary

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Summary

• AKI is prevalent in HIV and a risk factor for both CKD and death.

• HIV confers a risk of CKD that can rival DM.

• Renal transplant is a good option for HIV+ patients with outcomes comparable to HIV- recipients

• Continued efforts are needed to realize full potential of HOPE Act

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