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Tropical Infections in the Context of Kidney Transplantation in Latin America

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  • 1 Renal Transplant Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil;
  • | 2 Nephrology Division, Federal University of São Paulo, São Paulo, Brazil;
  • | 3 Department of Clinical Medicine, Federal University of Ceará, Fortaleza, Brazil;
  • | 4 Medical School, University of Fortaleza, Fortaleza, Ceará, Brazil;
  • | 5 Hospital Geral de Fortaleza, Fortaleza, Ceará, Brazil

ABSTRACT.

Reports on tropical infections among kidney transplant (KT) recipients have increased in recent years, mainly because of the growing number of KT programs located in tropical and subtropical areas, and greater mobility or migration between different areas of the world. Endemic in emerging and developing regions, like most countries in Latin America, tropical infections are an important cause of morbidity and mortality in this population. Tropical infections in KT recipients may exhibit different pathways for acquisition compared with those in nonrecipients, such as transmission through a graft and reactivation of a latent infection triggered by immunosuppression. Clinical presentation may differ compared with that in immunocompetent patients, and there are also particularities in diagnostic aspects, treatment, and prognosis. KT patients must be screened for latent infections and immunized properly. Last, drug–drug interactions between immunosuppressive agents and drugs used to treat tropical infections are an additional challenge in KT patients. In this review, we summarize the management of tropical infections in KT patients.

Author Notes

Address correspondence to Lúcio R. Requião-Moura, Rua Botucatu, 591, 15º Andar, Vila Clementino, São Paulo, Brazil, 04023-062. E-mail: lucio.moura@einstein.br

Financial support: This work was supported by the Programa de Apoio ao Desenvolvimento Institucional do Sistema Único de Saúde- PROADI-SUS program (Brazilian Health Ministry) and the National Council for Scientific and Technological Development (Conselho Nacional de Desenvolvimento Científico e Tecnológico).

Authors’ addresses: Lúcio R. Requião-Moura, Renal Transplant Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil, and Nephrology Division, Federal University of São Paulo, São Paulo, Brazil, E-mail: lucio.moura@einstein.br. Elizabeth De Francesco Daher, Savio de Oliveira Brilhante, Silvana Daher Costa, and Tainá Veras de Sandes-Freitas, Department of Clinical Medicine, Federal University of Ceará, Fortaleza, Brazil, E-mails: ef.daher@yahoo.com.br, saviobrilhante2009@hotmail.com, silvanadaher1@hotmail.com, and taina.sandes@gmail.com. Cassio R. Moreira Albino, Renal Transplant Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil, E-mail: kssio_rafael@hotmail.com. Geraldo Bezerra da Silva Jr., Medical School, University of Fortaleza, Fortaleza, Ceará, Brazil, E-mail: geraldobezerrajr@unifor.br.

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