[Kidney transplant in HBsAg+, HCV+ or HIV+ patients]

Hepatitis B and C virus infections are relatively common among patients with end-stage kidney disease on dialysis and kidney transplant recipients. These conditions are associated with increased morbidity and mortality after kidney transplant. Careful management of the transplant candidate by viral replication assessment and liver biopsy allows to achieve excellent kidney transplant results in these patients, also thanks to the antiviral therapies available today including pretransplant interferon for hepatitis C and nucleoside analogue reverse transcriptase inhibitors for hepatitis B. Until recently, human immunodeficiency virus (HIV) infection was an absolute contraindication to solid organ transplantation. At the end of the 1990s, it became clear that HIV infection, once a fatal disease, could be effectively turned into a chronic condition by the use of highly active antiretroviral therapy. As a result, a growing number of HIV patients develop HIV-associated end-stage renal disease. For this reason we have to reconsider kidney transplant as a possible treatment option. During the last decade, the results of many studies have shown that transplantation can be safe and effective in these patients, as long as HIV infection is effectively controlled by antiretroviral therapy.