Analysis of lymphocyte subsets in a renal allograft recipient infected with human immunodeficiency virus

OBJECTIVE To study the change in lymphocyte subsets of a renal allograft recipient who acquired human immunodeficiency virus (HIV) infection. PATIENT AND METHODS A 53-year-old Japanese man who acquired HIV infection at the time of renal transplantation and died from opportunistic infection 3 years later was studied. Lymphocyte subsets were examined serially throughout his clinical course. RESULTS The numbers of CD4 positive cells were severely decreased but those of CD8 positive cells were stable; the CD 4/8 ratio was extremely low. The numbers of B cells were also decreased but production of immunoglobulin was increased. In spite of this immunosuppressive state, graft rejection was noted when the patient's immunosuppressive medication was reduced. CONCLUSION The lymphocyte subsets of renal transplant patients with HIV infection should be closely observed, as should the nature and timing of opportunistic infection in relation to transplantation, and the administration of immunosuppressive medication.