HOPE in Action Prospective Multicenter, Clinical Trial of Deceased HIVD+ Kidney Transplants for HIV+ Recipients

This study will evaluate if receiving a kidney transplant from an HIV-infected deceased
kidney donor is safe with regards to survival and major transplant-related and HIV-related
complications compared to receiving a kidney from an HIV-uninfected deceased kidney donor
(HIVD-). Those participants who have accepted an HIVD- organ will be randomized to be
followed in the full study or followed in the nested observational group.

Inclusion Criteria:

- Participant meets the standard criteria for kidney transplant at the local center.

- Participant is able to understand and provide informed consent.

- Participant meets with an independent advocate per the HIV Organ Policy Equity (HOPE)
Act Safeguards.

- Documented HIV infection (by any licensed assay, or documented history of detectable
HIV-1 RNA).

- No living donor available.

- Participant is ≥18 years old.

- Opportunistic complications: if prior history of an opportunistic infection, the
participant has received appropriate therapy and has no evidence of active disease.

- Cluster of Differentiation 4 (CD4)+ T-cell: ≥200/µL within 16 weeks of transplant.

- HIV-1 is below 50 copies RNA/mL. Viral blips between 50-400 copies allowed as long as
there are not consecutive measurements >200 copies/mL.

- Participant is willing to comply with all medication related to their transplant and
HIV management.

- For participant with a history of aspergillus colonization or disease, no evidence of
active disease.

- The participant must have, or be willing to start seeing, a primary medical care
provider with expertise in HIV management.

- All participants participating in sexual activity that could lead to pregnancy must
use an FDA approved method of birth control.

- Participant is not suffering from significant wasting (e.g. body mass index <21)
thought to be related to HIV disease.

Exclusion Criteria:

- Participant has a history of progressive multifocal leukoencephalopathy (PML) or
primary central nervous system (CNS) lymphoma.

- Participant is pregnant or breastfeeding.

- Past or current medical problems or findings from medical history, physical
examination or laboratory testing that are not listed above, which, in the opinion of
the investigator, may pose additional risks or may impact the quality or
interpretation of the data obtained from the study.