We report the first case of a pregnancy in a renal transplant recipient with HIV infection. She underwent renal transplantation in 2005 and became pregnant in 2009. The patient underwent vaginal delivery and a healthy full-term, female baby was born. Almost 6 years after delivery, both mother and child were doing well. The management of concurrent renal transplantation, HIV infection and pregnancy was extremely challenging. Women with HIV infection who have undergone renal transplantation should be accurately informed of the potential health risks for them and their offspring. Multidisciplinary teams are mandatory in order to properly manage these patients.
References
1.
StockP.G., BarinB., MurphyB.Outcomes of kidney transplantation in HIV-infected recipients.N Engl J Med2010; 363: 2004–2014.
2.
MckayD.B., JosephsonM.A.Reproduction and transplantation: report on the AST Consensus Conference on Reproductive Issues and Transplantation.Am J Transpl2005; 5: 1592–1599.
3.
DeshpandeN.A., JamesN.T., KucirkaL.M.Pregnancy outcomes in kidney transplant recipients: a systematic review and meta-analysis.Am J Transplant2011; 11: 2388–2404.
4.
JosephsonM.A., McKayD.B.Pregnancy in the renal transplant recipient.Obstet Gynecol Clin North Am2010; 37: 211–222.
5.
BrocklehurstP., FrenchR.The association between maternal HIV infection and perinatal outcome: a systematic review of the literature and meta-analysis.Br J Obstet Gynaecol1998; 105: 836–848.
6.
ColbersA., GreupinkR., BurgerD.Pharmacological considerations on the use of antiretrovirals in pregnancy.Curr Opin Infect Dis2013; 26: 575–588.
7.
FrassettoL., FlorenL., BarinB.Changes in clearance, volume and bioavailability of immunosuppressants when given with HAART in HIV-1 infected liver and kidney transplant recipients.Biopharm Drug Dispos2013; 34: 442–451.
8.
SiegfriedN., van der MerweL., BrocklehurstP., SintT.T.Antiretrovirals for reducing the risk of mother-to-child transmission of HIV infection.Cochrane Database Syst Rev2011; 7: CD003510.
9.
SlykerJ.A., PattersonJ., AmblerG.Correlates and outcomes of preterm birth, low birth weight, and small for gestational age in HIV-exposed uninfected infants.BMC Pregnancy Childbirth2014; 14: 7.
10.
MorenoA., QueredaC., BárcenaR.Successful pregnancy after orthotopic liver transplantation in a patient with HIV infection.N Engl J Med2005; 353: 2517–2518.
11.
SchulteJ., DominguezK., SukalacT.Declines in low birth weight and preterm birth among infants who were born to HIV-infected women during an era of increased use of maternal antiretroviral drugs: pediatric spectrum of HIV disease, 1989–2004.Pediatrics2007; 119: e900–e906.
12.
Panel on Treatment of HIV-Infected Pregnant Women and Prevention of Perinatal Transmission.HIV-1-infected women for maternal health and interventions to recommendations for use of antiretroviral drugs in pregnant HIV-1-infected women for maternal health and interventions to reduce perinatal HIV transmission in the United States. (Accessed 10 July 2015.) Available from http://aidsinfo.nih.gov/contentfiles/lvguidelines/PerinatalGL.pdf.
13.
FuchsK.M., CoustanD.R.Immunosuppressant therapy in pregnant organ transplant recipients.Semin Perinatol2007; 31: 363–371.
14.
TricotL., TeicherE., PeytavinG.Safety and efficacy of raltegravir in HIV-infected transplant patients cotreated with immunosuppressive drugs.Am J Transplant2009; 9: 1946–1952.
