De Novo Belatacept in a Human Immunodeficiency Virus-Positive Kidney Transplant Recipient

Benefits of belatacept-based immunosuppressive regimens in human immunodeficiency virus (HIV)-positive renal transplant recipients include avoidance of drug interactions between calcineurin inhibitors and highly active antiretroviral agents and decreased likelihood or severity of nonimmune toxicities such as new-onset diabetes after transplant, hyperlipidemia and hypertension. We report a successful case of de novo belatacept at >18 mo from transplant in an HIV-positive black man aged 50 years who received his first transplant from a living related kidney donor. To our knowledge, this case is the first reported of belatacept use in an HIV-positive renal transplant recipient. In this case report, the authors discuss the de novo use of belatacept in an HIV-positive renal transplant recipient and the benefits and cautions of belatacept as primary immunosuppression in this patient population.