{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,18]],"date-time":"2025-04-18T13:27:39Z","timestamp":1744982859428},"reference-count":0,"publisher":"South African Medical Association NPC","license":[{"start":{"date-parts":[[2024,4,24]],"date-time":"2024-04-24T00:00:00Z","timestamp":1713916800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["S Afr Med J"],"abstract":"<jats:p>\n\n\n\nBackground. HIV\u2010infected kidney transplant recipients with COVID\u201019 are at increased risk of acute illness and death owing to their underlying comorbidities and chronic immunosuppression.\nObjectives. To describe the incidence, clinical presentation and course of COVID\u201019, vaccination status, and SARS\u2010CoV\u20102 antibody positivity rate among HIV\u2010infected\u2010to\u2010HIV\u2010infected kidney transplant recipients in South Africa (SA).\nMethods. This retrospective study reports on rates of SARS\u2010CoV\u20102 infection, COVID\u201019 and mortality among SA HIV\u2010infected kidney transplant recipients who received organs from HIV\u2010infected donors (HIV positive to HIV positive), before and after vaccination. Patient demographics, clinical presentation, course, management and disease outcomes were analysed. Antibody serology tests were performed between May and September 2022.\nResults. Among 39 HIV\u2010positive\u2010to\u2010HIV\u2010positive transplant recipients, 11 cases of COVID\u201019 were diagnosed from March 2020 to September 2022. Six patients (55%) required hospitalisation, of whom 3 were admitted to a high\u2010care unit or intensive care unit. Two patients required mechanical ventilation, and 2 received acute dialysis. One patient was declined access to intensive care. Four patients (10%) died of COVID\u201019 pneumonia. All the COVID\u201019\u2010positive patients had at least one comorbidity. Vaccination data were available for 24 patients, of whom 5 had refused SARS\u2010CoV\u20102 vaccination. SARS\u2010CoV\u20102 antibody data were available for 20 patients; 4 vaccinated patients had a negative nucleocapsid protein antibody test and a positive spike protein antibody test, suggesting vaccination\u2010acquired immunity. The remaining 16 patients demonstrated immunity that was probably due to COVID infection, and of these, 14 were also vaccinated. Of the 11 COVID\u201019 cases, only 1 was observed after vaccination.\nConclusion. In our case series, ~10% of the HIV\u2010positive\u2010to\u2010HIV\u2010positive transplant recipients died of COVID\u201019 pneumonia. This mortality rate appears higher than figures reported in other transplant cohorts. However, it is likely that the actual number of cases of SARS\u2010CoV\u20102 infection was much higher, as the study only included polymerase chain reaction\u2010confirmed cases. It remains unclear whether HIV infection, transplant or the combination of the two drives poorer outcomes, and larger studies adjusting for important demographic and biological factors may isolate these effects.\n\n\n\n<\/jats:p>","DOI":"10.7196\/samj.2024.v114i3b.1374","type":"journal-article","created":{"date-parts":[[2024,5,23]],"date-time":"2024-05-23T10:41:07Z","timestamp":1716460867000},"page":"e1374","source":"Crossref","is-referenced-by-count":1,"title":["Clinical course, management and outcomes of COVID-19 in HIV-infected renal transplant recipients: A case series"],"prefix":"10.7196","author":[{"given":"L","family":"Bertels","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K","family":"Manning","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Redd","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T","family":"Du Toit","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Z","family":"Barday","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E","family":"Muller","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"4425","published-online":{"date-parts":[[2024,4,24]]},"container-title":["South African Medical Journal"],"original-title":[],"link":[{"URL":"https:\/\/samajournals.co.za\/index.php\/samj\/article\/download\/1374\/892","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/samajournals.co.za\/index.php\/samj\/article\/download\/1374\/892","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,31]],"date-time":"2024-05-31T10:56:00Z","timestamp":1717152960000},"score":1,"resource":{"primary":{"URL":"https:\/\/samajournals.co.za\/index.php\/samj\/article\/view\/1374"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,24]]},"references-count":0,"URL":"https:\/\/doi.org\/10.7196\/samj.2024.v114i3b.1374","relation":{},"ISSN":["2078-5135","0256-9574"],"issn-type":[{"value":"2078-5135","type":"electronic"},{"value":"0256-9574","type":"print"}],"subject":[],"published":{"date-parts":[[2024,4,24]]}}}