Kidney disease in human immunodeficiency virus-seropositive patients: Absence of human immunodeficiency virus-associated nephropathy was a characteristic feature

Abstract

Human immunodeficiency virus (HIV) infection can cause a broad spectrum of renal diseases. However, there is paucity of Indian data on the patterns of renal lesions in HIV-seropositive patients. The aim of the present study was to delineate the spectrum of renal lesions in HIV/acquired immunodeficiency syndrome patients. In this prospective study, all HIV-positive patients of both genders aged >18 years were screened for renal disease. Patients with proteinuria of more than 1 g/24 h were subjected to renal biopsy. A total of 293 HIV-positive patients were screened; of these, 136 (46.4%) patients found to have renal involvement. Dipstick-positive proteinuria of 1+ or more was observed in 112 (38.2%) patients, and 16 (14.2%) patients had proteinuria of more than 1 g/24 h. Renal biopsy in 14 cases revealed glomerulonephritis (GN) in 12 (85.7%) (isolated GN in 4 [28.5%] and GN mixed with chronic TIN in 8 [57.1%]) patients. These include mesangioproliferative GN in 5 (35.7%), membranoproliferative GN in 2 (14.2%), focal segmental glomerulosclerosis in 2 (14.2%), diffuse proliferative GN in 2 (14.2%), and diabetic nephropathy in 1 (7.1%) patients. Chronic interstitial nephritis was noted in 10 (71.42%) (superimposed on GN in 8 [57.1%], isolated in 2 [14.2%]) patients. Granulomatous interstitial nephritis was seen in 3 (24.1%) cases. GN and chronic interstitial nephritis were noted in 85.7% and 71.42% of patients, respectively, mostly superimposed on each other. Mesangioproliferative GN was the most common glomerular lesion, but classical HIV-associated nephropathy was not observed.

A study of the renal profile in ART naive HIV/AIDS patients

“…No patient in the present study had nephrotic range proteinuria. Proteinuria > 1g/day was found in 4 cases (10%) in the present study which was similar to Prakash J. et al, 9 who found 16(14.2%) patients to have proteinuria of more than 1g/24h. The mean serum creatinine of the total study population was found to be 0.92±0.83 mg/dl.…”

Prevalence of Renal Dysfunction in ART Naive HIV Positive Patients in Manipur, North East India

“…No patient in present study had nephrotic range proteinuria. Proteinuria >1g/day was found in 9(17.3%) cases in the present study, which was similar to Prakash J et al [3] who found 16/112 (14.2%) patients to have proteinuria >1g/day.…”

“…Similarly, Gupta V et al [5] reported that 58/392 (14.79%) in ART naïve cases to have proteinuria. While Janakiraman H et al [9] reported 29/104 (27%) cases and Prakash J et al [3] reported 112/ 293 (38.2%) cases to have proteinuria. The discrepancy in the later two studies was probably due to inclusion of HIV patients already on ART and also due to difference in sample size.…”

“…[2] Renal d isease is a relatively common co mplication in HIV patients and prevalence is about 5-30%. [3,4] Several studies about the renal profile of HIV/AIDS patients have been done in other parts of India but data from the north east India is lacking. [5,6,7,8] Spectrum o f renal diseases in patients with HIV/AIDS is wide and can range fro m simply acid base disturbances to AKI and several glo merular lesions such as IgA nephropathy, memb ranous -nephropathy, memb ranoproliferative, mesangial proliferative, diffuse proliferative, or crescentic glo meru lonephritis.…”

Histological spectrum of renal disease in HIV/AIDS patients with significant proteinuria: An Indian perspective

“…[78] The available studies from India differ strikingly, with some studies showing presence of HIVAN,[91011] whereas others reporting complete absence of this entity. [81213] With this perspective, the present study was carried out to elucidate the histological spectrum of renal disease in HIV patients from a tertiary care center from India. Kidney biopsies were performed in HIV patients with proteinuria ≥1 g/day, to delineate the glomerular lesions including presence of possible HIVAN.…”