Revista de SIDA e investigación clínica

Impact of Renal Transplantation on Psychosocial Status of Human Immuno Deficiency Virus (HIV) Positive Patients

Abstract

DK Agarwal, Aditya Agarwal, Nalin Nag, Swapnil Y Gajway and Satyabrat Garanayak

Background and Methods: Nephropathy is a common complication amongst the HIV positive population. With the advent of Combined Anti-Retroviral Therapy (cART), CD4+ counts and viral replication can be controlled more efficiently. The survival rates are fast approaching that of the general population. In such a scenario, renal transplantation is growing increasingly popular as a treatment modality of End Stage Renal Disease (ESRD) in HIV positive patients.

We studied the psychosocial changes in a subset of such HIV positive renal transplant recipients through a questionnaire which assessed multiple parameters with fixed multiple choice responses. An attempt was made to compare the pre and post-transplant psychosocial status of the patients wherever possible. We selected ten HIV positive patients who had undergone renal transplantation at our center at least one year prior to the study.

Results: Nine out of ten patients (90%) reported better quality of life, an increase in professional productivity and perceived an improvement in behavior of the spouse and colleagues towards them. Out of nine patients who were sexually active, seven (77%) experienced an improvement in their sexual relationship. However, seven (70%) patients recalled that they underwent substantial anxiety and feared an unsuccessful transplant and the relapse of HIV prior to the surgery, while six (60%) answered that they live in constant fear of an HIV relapse even after the surgery. According to all of them, the prominent factors limiting renal transplantation in HIV positive patients were substantial cost and lack of awareness of kidney transplantation as a possible option for them.

Conclusion: Renal Transplantation had a definite positive impact on the psychosocial status of HIV positive renal transplant recipients, enhancing multiple facets like quality of life, sexual relationships and professional life amongst others. Although it was a source of fear and anxiety for some. A larger study with more patients would definitely be more illuminating.