Membranous glomerulonephritis with nephrotic syndrome in a HIV positive patient—remarkable remission with triple therapy

The clinical epidemiology and course of the spectrum of renal diseases associated with HIV infection

“…While no patient who received antiretroviral therapy experienced a doubling of serum creatinine or the progression to ESRD, the small number of patients available for inclusion, and the limited information regarding histology of renal lesions, limits the power and conclusions that may be drawn from this study. Similarly, case reports of a patient with membranous nephropathy and immune-complex nephropathy demonstrate a reduction in proteinuria [13,22] and stable renal course [22] temporally related to changes in antiretroviral regimen that resulted in reduction in HIV-1 RNA levels. Small sample size and limited follow-up also limit the conclusions that may be drawn from these case reports.…”

“…While the most common histologic lesion seen among HIV-infected patients with renal disease is HIV-associated nephropathy (HIVAN), a glomerulopathy demonstrating focal segmental glomerulosclerosis with collapsing features, a spectrum of other histologic lesions occurs with almost an equal cumulative frequency [2]. These lesions include amyloidosis, minimal change disease, cryoglobulinemia, and various forms of immune-complex glomerulonephritis, such as IgA nephropathy, membranous nephropathy, and membranoproliferative glomerulonephritis [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18]. While an understanding of the epidemiology and clinical course of HIVAN is growing, little is known about the risk factors and clinical course of the other renal diseases that may also occur as a complication of HIV infection.…”

HIV-associated immune complex glomerulonephritis with “lupus-like” features: A clinicopathologic study of 14 cases

“…His renal function remained stable while he received HAART, but rapidly deteriorated to ESRD during an interval when HAART was discontinued and his HIV viral load increased. There are additional case reports of HIV-positive patients with immune complexmediated glomerular diseases showing reduction of proteinuria following treatment with multidrug antiretroviral regimens [25,26], although a recent multicenter study failed to show a significant effect of antiretroviral therapy on renal survival in HIV-positive patients with a variety of glomerular lesions other than HIVAN, most immune complex-mediated [27]. Five of our patients were treated with HAART and two showed an improvement in renal function that was stable 42 and 43 months after the biopsy, respectively.…”

Idiopathic Membranous Nephropathy: Diagnostic and Therapeutic Challenges

“…Aydin et al [21] reported a case of MN in a patient with recently diagnosed HIV without coinfections whose proteinuria decreased following treatment with ACE and HAART, indicating that MN may have been secondary to HIV. Alarcón-Zurita et al [22] reported a similar case of MN in a patient positive for HIV and hepatitis C whose kidney disease responded to HAART. Chen et al [23] reported a case of MN in a patient with HIV who was diagnosed with syphilis and who responded positively to renal disease when treated with penicillin.…”