Maximizing the success of HIV+ to HIV+ kidney transplantation in South Africa

最大限度地提高南非艾滋病毒肾移植的成功率

• 批准号: 10370410
• 负责人: Elmi Muller
• 金额: $ 18.02万
• 依托单位: UNIVERSITY OF CAPE TOWN
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-04-06 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10370410
• 关键词: Affect; Africa; Antithymoglobulin; Area; Biological; Caring; Cells; Cellular Infiltration; Clinical; Clinical Management; Cohort Studies; Communicable Diseases; DNA; Data; Disease; End stage renal failure; Environment; Face; Functional disorder; Graft Survival; HIV; HIV Seronegativity; Immune response; Immunologics; Immunomodulators; Immunosuppressive Agents; International; Kidney; Kidney Failure; Kidney Transplantation; Laboratories; Lead; Life; Liver diseases; Operative Surgical Procedures; Organ; Organ Transplantation; Pathology; Patients; Phase; Population; Procedures; Proviruses; Public Health; Research; Risk; Role; Savings; Services; South Africa; Spain; Survival Rate; Tissues; Transplant Recipients; Transplantation; Viral; Viral reservoir; Virus Latency; Work; base; clinical decision-making; clinical practice; cohort; comorbidity; cytokine; experience; follow-up; graft function; immune activation; improved; innovation; mTOR Inhibitor; member; novel; organ transplant recipient; organ transplant rejection; post-transplant; potential biomarker; prevent; programs; success; superinfection; underserved area; uptake

Project Summary: We previously demonstrated that the patient and graft survival rates for HIV+ to HIV+ kidney transplants are comparable to rates seen in other HIV+ transplant recipients. We also showed that these transplants do not result in sustained HIV superinfection despite presence of a detectable donor viral inoculum in these recipients, alleviating one of the major concerns with these surgeries. This proposal aims to expand on these novel findings by initially exploring how the immune modulators these patients receive may affect the HIV latent viral reservoir, which is the primary hurdle in the search for an HIV cure. In addition, we and others have observed a possible increased risk of rejection in HIV+ kidney transplant recipients in general. Therefore, we have partnered with the HIV transplant and pathology groups at UCSF, as well as a team of other collaborators from the US, Spain, and South Africa, to examine the role of several components of the immune response associated with organ rejection. We will also utilize this diverse team of experts in HIV infectious disease, pathology, and transplantation to increase clinical and laboratory support for transplantation services in underserved areas in South Africa, thereby increasing availability of these life- saving transplants. The results of this study will have a direct and immediate influence on transplant clinical practice in South Africa and the US. Additionally, our study provides an opportunity to answer multiple fundamental biological questions surrounding HIV cure research and HIV related organ rejection.

项目概要： 我们以前证明，HIV+到HIV+肾移植的患者和移植物存活率是 与其他HIV+移植受者的比率相当。我们还发现，这些移植并不 导致持续的HIV重复感染，尽管在这些受体中存在可检测的供体病毒接种物， 缓解了这些手术的主要问题之一。 该提案旨在通过初步探索免疫调节剂如何影响这些新发现来扩展这些新发现。 患者接受可能会影响HIV潜伏病毒库，这是寻找HIV的主要障碍。 疗方此外，我们和其他人观察到HIV+肾移植的排斥风险可能增加 一般的收件人。因此，我们与UCSF的HIV移植和病理学小组合作， 以及来自美国、西班牙和南非的其他合作者组成的团队，研究了几个 与器官排斥相关的免疫反应的组成部分。我们还将利用这一多元化的团队， 艾滋病毒感染性疾病、病理学和移植方面的专家，以增加临床和实验室支持， 在南非服务不足的地区提供移植服务，从而增加这些生命的可用性- 拯救移植 这项研究的结果将对南方的移植临床实践产生直接和直接的影响。 非洲和美国。此外，我们的研究提供了一个机会来回答多种基本的生物学问题。 围绕艾滋病毒治愈研究和艾滋病毒相关器官排斥反应的问题。