Didanosine administration in a human immunodeficiency virus-positive renal transplant patient

A human immunodeficiency virus-positive renal transplant patient taking no immunosuppressive medication for 40 months was treated with didanosine for the final 13 months of life. Over the latter period there were three acute episodes of creatinine elevation, but none could be attributed to didanosine-induced acute rejection. Based on this case, we cautiously suggest that didanosine may safely be administered in the setting of renal transplantation.