HOPE in Action Prospective Multicenter, Clinical Trial of Deceased HIVD+ Kidney Transplants for HIV+ Recipients

The primary objective is to determine if an HIV+ kidney donor transplant is safe with regards to major transplant-related and HIV-related complications. The secondary objectives are to compare other clinical outcomes between HIV+ transplant recipients of kidneys from HIV+ and HIV- donors. Exploratory objectives are to explore HIV-superinfection, changes in the HIV latent reservoir, ethical, and patient reported psychosocial outcomes.

Inclusion Criteria:

• Participant meets the standard criteria for kidney transplant at the local center.
• Participant is able to understand and provide informed consent.
• Participant meets with an independent advocate per the HIV Organ Policy Equity (HOPE) Act Safeguards.
• Documented HIV infection (by any licensed assay, or documented history of detectable HIV-1 RNA).
• No living donor available.
• Participant is ≥18 years old.
• Opportunistic complications: if prior history of an opportunistic infection, the participant has received appropriate therapy and has no evidence of active disease.
• Cluster of Differentiation 4 (CD4)+ T-cell: ≥200/µL within 16 weeks of transplant.
• HIV-1 is below 50 copies RNA/mL. Viral blips between 50-400 copies allowed as long as there are not consecutive measurements >200 copies/mL.
• Participant is willing to comply with all medication related to their transplant and HIV management.
• For participant with a history of aspergillus colonization or disease, no evidence of active disease.
• The participant must have, or be willing to start seeing, a primary medical care provider with expertise in HIV management.
• All participants participating in sexual activity that could lead to pregnancy must use an FDA approved method of birth control.
• Participant is not suffering from significant wasting (e.g. body mass index <21) thought to be related to HIV disease.

Exclusion Criteria:

• Participant has a history of progressive multifocal leukoencephalopathy (PML) or primary central nervous system (CNS) lymphoma.
• Participant is pregnant or breastfeeding.
• Past or current medical problems or findings from medical history, physical examination or laboratory testing that are not listed above, which, in the opinion of the investigator, may pose additional risks or may impact the quality or interpretation of the data obtained from the study.