Analysis of HIV quasispecies and virological outcome of an HIV D+/R+ kidney–liver transplantation
Abstract Introduction Transplantation among HIV positive patients may be a valuable therapeutic intervention. This study involves an HIV D+/R+ kidney–liver transplantation, where PBMC-associated HIV quasispecies were analyzed in donor and transplant recipients (TR) prior to transplantation and there...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-01-01
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| Series: | Virology Journal |
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| Online Access: | https://doi.org/10.1186/s12985-021-01730-w |
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| author | Gabriella Rozera Ubaldo Visco-Comandini Emanuela Giombini Francesco Santini Federica Forbici Giulia Berno Cesare Gruber Paolo De Paolis Roberto Colonnelli Gianpiero D’Offizi Giuseppe Maria Ettorre Paolo Grossi Maria Rosaria Capobianchi Giuseppe Ippolito Isabella Abbate |
| author_facet | Gabriella Rozera Ubaldo Visco-Comandini Emanuela Giombini Francesco Santini Federica Forbici Giulia Berno Cesare Gruber Paolo De Paolis Roberto Colonnelli Gianpiero D’Offizi Giuseppe Maria Ettorre Paolo Grossi Maria Rosaria Capobianchi Giuseppe Ippolito Isabella Abbate |
| author_sort | Gabriella Rozera |
| collection | DOAJ |
| description | Abstract Introduction Transplantation among HIV positive patients may be a valuable therapeutic intervention. This study involves an HIV D+/R+ kidney–liver transplantation, where PBMC-associated HIV quasispecies were analyzed in donor and transplant recipients (TR) prior to transplantation and thereafter, together with standard viral monitoring. Methods The donor was a 54 year of age HIV infected woman: kidney and liver recipients were two HIV infected men, aged 49 and 61. HIV quasispecies in PBMC was analyzed by ultra-deep sequencing of V3 env region. During TR follow-up, plasma HIV-1 RNA, HIV-1 DNA in PBMC, analysis of proviral integration sites and drug-resistance genotyping were performed. Other virological and immunological monitoring included CMV and EBV DNA quantification in blood and CD4 T cell counts. Results Donor and TR were all ART-HIV suppressed at transplantation. Thereafter, TR maintained a nearly suppressed HIV-1 viremia, but HIV-1 RNA blips and the increase of proviral integration sites in PBMC attested some residual HIV replication. A transient peak in HIV-1 DNA occurred in the liver recipient. No major changes of drug-resistance genotype were detected after transplantation. CMV and EBV transient reactivations were observed only in the kidney recipient, but did not require specific treatment. CD4 counts remained stable. No intermixed quasispecies between donor and TR was observed at transplantation or thereafter. Despite signs of viral evolution in TR, HIV genetic heterogeneity did not increase over the course of the months of follow up. Conclusions No evidence of HIV superinfection was observed in the donor nor in the recipients. The immunosuppressive treatment administrated to TR did not result in clinical relevant viral reactivations. |
| first_indexed | 2024-12-20T06:42:56Z |
| format | Article |
| id | doaj.art-603d04e12f4940ac95f60b8e2dc09a64 |
| institution | Directory Open Access Journal |
| issn | 1743-422X |
| language | English |
| last_indexed | 2024-12-20T06:42:56Z |
| publishDate | 2022-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Virology Journal |
| spelling | doaj.art-603d04e12f4940ac95f60b8e2dc09a642022-12-21T19:49:48ZengBMCVirology Journal1743-422X2022-01-011911810.1186/s12985-021-01730-wAnalysis of HIV quasispecies and virological outcome of an HIV D+/R+ kidney–liver transplantationGabriella Rozera0Ubaldo Visco-Comandini1Emanuela Giombini2Francesco Santini3Federica Forbici4Giulia Berno5Cesare Gruber6Paolo De Paolis7Roberto Colonnelli8Gianpiero D’Offizi9Giuseppe Maria Ettorre10Paolo Grossi11Maria Rosaria Capobianchi12Giuseppe Ippolito13Isabella Abbate14Virology Unit, National Institute for Infectious Diseases, I.R.C.C.S. L.SpallanzaniHepatology Unit, P.O.I.T. San Camillo-SpallanzaniVirology Unit, National Institute for Infectious Diseases, I.R.C.C.S. L.SpallanzaniVirology Unit, National Institute for Infectious Diseases, I.R.C.C.S. L.SpallanzaniVirology Unit, National Institute for Infectious Diseases, I.R.C.C.S. L.SpallanzaniVirology Unit, National Institute for Infectious Diseases, I.R.C.C.S. L.SpallanzaniVirology Unit, National Institute for Infectious Diseases, I.R.C.C.S. L.SpallanzaniNefrology Unit, P.O.I.T. San Camillo-SpallanzaniNefrology Unit, P.O.I.T. San Camillo-SpallanzaniHepatology Unit, P.O.I.T. San Camillo-SpallanzaniSurgical Unit, P.O.I.T. San Camillo-SpallanzaniInsubria UniversityVirology Unit, National Institute for Infectious Diseases, I.R.C.C.S. L.SpallanzaniScientific Direction, National Institute for Infectious Diseases, I.R.C.C.S. L.SpallanzaniVirology Unit, National Institute for Infectious Diseases, I.R.C.C.S. L.SpallanzaniAbstract Introduction Transplantation among HIV positive patients may be a valuable therapeutic intervention. This study involves an HIV D+/R+ kidney–liver transplantation, where PBMC-associated HIV quasispecies were analyzed in donor and transplant recipients (TR) prior to transplantation and thereafter, together with standard viral monitoring. Methods The donor was a 54 year of age HIV infected woman: kidney and liver recipients were two HIV infected men, aged 49 and 61. HIV quasispecies in PBMC was analyzed by ultra-deep sequencing of V3 env region. During TR follow-up, plasma HIV-1 RNA, HIV-1 DNA in PBMC, analysis of proviral integration sites and drug-resistance genotyping were performed. Other virological and immunological monitoring included CMV and EBV DNA quantification in blood and CD4 T cell counts. Results Donor and TR were all ART-HIV suppressed at transplantation. Thereafter, TR maintained a nearly suppressed HIV-1 viremia, but HIV-1 RNA blips and the increase of proviral integration sites in PBMC attested some residual HIV replication. A transient peak in HIV-1 DNA occurred in the liver recipient. No major changes of drug-resistance genotype were detected after transplantation. CMV and EBV transient reactivations were observed only in the kidney recipient, but did not require specific treatment. CD4 counts remained stable. No intermixed quasispecies between donor and TR was observed at transplantation or thereafter. Despite signs of viral evolution in TR, HIV genetic heterogeneity did not increase over the course of the months of follow up. Conclusions No evidence of HIV superinfection was observed in the donor nor in the recipients. The immunosuppressive treatment administrated to TR did not result in clinical relevant viral reactivations.https://doi.org/10.1186/s12985-021-01730-wHIVSolid organ transplantationQuasispeciesViral reactivation |
| spellingShingle | Gabriella Rozera Ubaldo Visco-Comandini Emanuela Giombini Francesco Santini Federica Forbici Giulia Berno Cesare Gruber Paolo De Paolis Roberto Colonnelli Gianpiero D’Offizi Giuseppe Maria Ettorre Paolo Grossi Maria Rosaria Capobianchi Giuseppe Ippolito Isabella Abbate Analysis of HIV quasispecies and virological outcome of an HIV D+/R+ kidney–liver transplantation Virology Journal HIV Solid organ transplantation Quasispecies Viral reactivation |
| title | Analysis of HIV quasispecies and virological outcome of an HIV D+/R+ kidney–liver transplantation |
| title_full | Analysis of HIV quasispecies and virological outcome of an HIV D+/R+ kidney–liver transplantation |
| title_fullStr | Analysis of HIV quasispecies and virological outcome of an HIV D+/R+ kidney–liver transplantation |
| title_full_unstemmed | Analysis of HIV quasispecies and virological outcome of an HIV D+/R+ kidney–liver transplantation |
| title_short | Analysis of HIV quasispecies and virological outcome of an HIV D+/R+ kidney–liver transplantation |
| title_sort | analysis of hiv quasispecies and virological outcome of an hiv d r kidney liver transplantation |
| topic | HIV Solid organ transplantation Quasispecies Viral reactivation |
| url | https://doi.org/10.1186/s12985-021-01730-w |
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