Pattern of glomerular involvement in human immunodeficiency virus—infected patients: An Italian study

Casanova, S.; Mazzucco, Gianna; Belgiojoso, G. Barbiano di; Motta, Manuela; Boldorini, Renzo; Genderini, A.; Monga, Guido

doi:10.1016/0272-6386(95)90490-5

Cited by 82 publications

(47 citation statements)

References 11 publications

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“…Infective endocarditis, HIV, and HBV and HBC infections are associated with renal pathologic patterns similar to those previously described in heroin users (123)(124)(125)(126)(127)(128)(129)(130)(131)(132)(133)(134)(135)(136)(137). Because reports of heroin-associated nephropathy predated the surveillance of HCV and HIV infection with serologic and virologic tools, it is conceivable that some of the various histologic findings might have been related to the spectrum of viral illnesses that are encountered in injection drug users (3).…”

Section: Historical Perspective Of Renal Disease and Heroin Usesupporting

confidence: 68%

“…Unfortunately, investigators have focused largely on descriptive studies (132). Common co-infections with HIV, HCV, HBV, and endocarditis in intravenous drug users may manifest similar histologic presentations as those described in patients who had unrelated renal disease and used heroin (123)(124)(125)(126)(127)(128)(129)(130)(131)(132)(133)(134)(135)(136)(137). Because reports of "heroin nephropathy" occurred before the identification of HCV and the dissemination of virologic, serologic, and molecular biologic diagnostic tools, it is conceivable that some of the variation in the histologic findings might have been related to the spectrum of viral illnesses that are encountered in injection drug users (3).…”

Section: Resultsmentioning

confidence: 87%

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Chronic Nephropathies of Cocaine and Heroin Abuse

Jaffe

Kimmel²

2006

Clinical Journal of the American Society of Nephrology

124

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Renal disease in cocaine and heroin users is associated with the nephrotic syndrome, acute glomerulonephritis, amyloidosis, interstitial nephritis, and rhabdomyolysis. The pathophysiologic basis of cocaine-related renal injury involves renal hemodynamic changes, glomerular matrix synthesis and degradation, and oxidative stress and induction of renal atherogenesis. Heroin is the most commonly abused opiate in the United States. Previous studies identified a spectrum of renal diseases in heroin users. The predominant renal lesion in black heroin users is focal segmental glomerulosclerosis and in white heroin users is membranoproliferative glomerulonephritis. Although the prevalence of heroin use in the United States has increased, the incidence of "heroin nephropathy" has declined. Because reports of heroin nephropathy predated the surveillance of hepatitis C virus and HIV, the varied findings might be related to the spectrum of viral illnesses that are encountered in injection drug users. Socioeconomic conditions, cultural and behavioral practices, or differences in genetic susceptibilities may be more associated with the development of nephropathy in heroin users than the drug's pharmacologic properties. Administration of cocaine in animal models results in nonspecific glomerular, interstitial, and tubular cell lesions, but there is no animal model of heroin-associated renal disease. The heterogeneity of responses that are associated with heroin is not consistent with a single or simple notion of nephropathogenesis. There are no well-designed, prospective, epidemiologic studies to assess the incidence and the prevalence of renal disease in populations of opiate users and to establish the validity of a syndrome such as heroin nephropathy. It is concluded although there is a paucity of evidence to support a heroinassociated nephropathy, the evidence from in vitro cellular and animal studies to support the existence of cocaine-induced renal changes is more convincing.

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Section: Historical Perspective Of Renal Disease and Heroin Usesupporting

confidence: 68%

Section: Resultsmentioning

confidence: 87%

Chronic Nephropathies of Cocaine and Heroin Abuse

Jaffe

Kimmel²

2006

Clinical Journal of the American Society of Nephrology

124

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“…Prior studies suggest that individuals with HIVICK present with significant but lower degrees of proteinuria and similar immunocompromise as those with HIVAN and with variable degrees of kidney dysfunction (13)(14)(15)(16)(17); these studies, however, were primarily conducted either in the era preceding the availability of combination antiretroviral therapy (cART) or were composed of study populations in which few participants were receiving cART. Furthermore, the majority of these studies were conducted in regions outside the United States.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Risk Factors and Outcomes in HIV Immune Complex Kidney Disease and HIV-Associated Nephropathy

Foy

Estrella²,

Lucas³

et al. 2013

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives HIV-associated nephropathy (HIVAN) is well described, but the clinical features of a group of renal pathologies characterized by Ig or immune complex depositions referred to as HIV-associated immune complex kidney disease (HIVICK) have not been well established. The objective of this study is to assess risk factors for HIVICK compared with contemporaneous control participants.Design, setting, participants, & measurements A nested case-control study of 751 HIV-infected patients followed from January 1996 to June 2010 was conducted. Groups were compared using the chi-squared test or ranksum analysis. Conditional logistic regression was used to estimate odds ratios (ORs) for HIVICK. Incidences of overall ESRD and with/without combined antiretroviral therapy (cART) exposure were calculated.Results HIVICK patients were predominantly African American (92%). Compared with matched controls, patients with HIVICK were more likely to have HIV RNA .400 copies/ml (OR, 2.5; 95% confidence interval [95% CI], 1.2 to 5.2), diabetes (OR, 2.8; 95% CI, 1.1 to 6.8), and hypertension (OR, 2.3; 95% CI, 1.2 to 4.5). Compared with HIVAN, patients with HIVICK had more antiretroviral therapy exposure, lower HIV viral loads, and higher CD4 and estimated GFR. ESRD was less common in the HIVICK versus the HIVAN group (30% versus 82%; P,0.001), and the use of cART was not associated with ESRD in HIVICK patients (25% versus 26; P=0.39).Conclusions HIVICK was predominantly observed in African-American patients and associated with advanced HIV disease. ESRD incidence is lower in HIVICK patients compared with those with HIVAN. Unlike HIVAN, cART use was not associated with the incidence of ESRD in HIVICK.

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“…Recent reports suggest that the same pattern is not observed in various European countries, with a higher proportion of cases attributed to HIV-HUS and immune-mediated glomerulonephritis. 3,4 Although there is lack of epidemiological data concerning other parts of the world, the incidence of HIV-FSGS in African descendents outside the US does not seem to be so high. 5 HIV-associated nephropathy can occur in any phase of the HIV infection, including acute seroconversion, but is usually seen later in the disease, when viral load is higher.…”

Section: Discussionmentioning

confidence: 99%