Many aspects of kidney transplantation in HIV+ recipients remain unclear: the increased acute rejection rate in comparison to HIV negative recipients, the interaction between anti-retroviral therapy and immunosuppressive drugs, and the control of HIV replication to prevent opportunistic infections.

Our immunosuppression scheme is based on mTOR inhibitors and very low-exposed cyclosporine. This strategy allows prevention of chronic drug-induced renal toxicity and from the other side might reduce the risk of viral infections and neoplasms while protecting from rejection.

Raltegravir and enfuvirtide did not alter appreciably everolimus, sirolimus, and cyclosporine through blood level, confirming the low potential for pharmacokinetic interactions of these drugs with IS therapy.