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

项目总结： 我们以前曾证明，艾滋病毒到艾滋病毒的肾脏移植的患者和移植物存活率是 与其他艾滋病毒移植接受者的发病率相当。我们还表明，这些移植不会 导致持续的艾滋病毒重叠感染，尽管在这些接受者中存在可检测到的供体病毒接种， 缓解了这些手术的主要担忧之一。 这项提案旨在通过初步探索免疫调节剂如何在这些新发现的基础上进行扩展 患者收到的病毒可能会影响艾滋病毒的潜伏病毒库，这是寻找艾滋病毒的主要障碍 解药。此外，我们和其他人观察到艾滋病毒肾移植可能增加了排斥反应的风险。 一般情况下，收件人。因此，我们与加州大学旧金山分校的艾滋病毒移植和病理小组合作，因为 以及来自美国、西班牙和南非的其他合作者组成的团队，以检查几个 与器官排斥反应有关的免疫反应的组成部分。我们还将利用这个多样化的团队 艾滋病毒感染疾病、病理学和移植方面的专家，以增加对艾滋病的临床和实验室支持 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获得性 挽救移植手术。 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回答多个基本生物学问题的机会 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。

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.