Renal disease in AIDS: it is not always HIVAN

Bani-Hani, Samer; Patel, Vikul; Larsen, Christopher P.; Walker, Patrick D.; Cooke, Colin R.; Showkat, Arif

doi:10.1007/s10157-009-0253-8

Cited by 9 publications

(4 citation statements)

References 21 publications

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“…[9] HIV-related renal diseases include various histological spectrum that consists of HIVAN, HIVICK, thrombotic microangiopathy, cART-related nephropathies, and comorbidities-associated nephropathies in HIV patients (such as HCV infection, hypertension, and diabetes). [1011] AIDS-associated nephropathy – known as HIVAN – was first reported in the United States in 1984. [3] HIVAN results from direct viral interaction of renal cells or the action of viral proteins.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2017

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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.

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Section: Discussionmentioning

confidence: 99%

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

et al. 2017

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“…As the cause of the renal disease in this patient, HIV-associated nephropathy (HIVAN), classic type FSGS, and various types of GN that are often observed during HIV-1 infection have to be considered [1][2][3][4][5] (Table 1). HIVAN, however, is unlikely to account for the renal manifestations.…”

Section: Hiv-1 Infection and Renal Leishmaniasismentioning

confidence: 99%

Renal Leishmaniasis as Unusual Cause of Nephrotic Syndrome in an HIV Patient

Amann

Bogdan²,

Harrer³

et al. 2012

Journal of the American Society of Nephrology

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Renal involvement is a rare complication in HIV-1-infected patients leading to various pathologies and clinical symptoms. In addition to the classic HIV-1-associated nephropathy with collapsing-type focal segmental glomerulosclerosis and characteristic tubulocystic changes, which is more common in Afro-American than in Caucasian HIV-1 patients, immune complex GNs such as membranous GN and membranoproliferative GN are particularly common renal manifestations. Besides HIV-1 itself, a number of opportunistic infections may cause renal disease in HIV-1-infected patients. In this study, we report an unusual case of HIV-1 infection with a severe renal manifestation of systemic leishmaniasis that developed years after repeated visits to Mediterranean countries. The case presents several remarkable clinical, pathologic, and therapeutic aspects that may be important for daily clinical practice. 23: 586-590, 201223: 586-590, . doi: 10.1681 In April 2008, a 45-year-old Caucasian male patient was admitted to our hospital due to dyspnea and recurrent diarrhea during the past weeks. He had been known to be HIV-1 infected for 23 years, and he had been treated with various antiretroviral drug regimens since 1997. Despite therapy, he had experienced progressive immunodeficiency due to poor compliance and drug resistance. At a prior visit to our hospital in 2001, he had presented with a high viremia (500,000 copies/ml) and depleted CD4 cells (3/ml). At the current admission, he was on an antiretroviral combination regimen consisting of darunavir, low-dose ritonavir, tenofovir, and emtricitabine. J Am Soc NephrolPhysical examination revealed an elevated blood pressure of 170/110 mmHg, dyspnea, bilateral pleura effusions, gross edema of legs, scrotum, and penis, and reddish, macular and papular skin lesions on the dorsal hands, chest, abdomen, and thighs. Laboratory analyses showed abnormal renal parameters (serum creatinine 1.49 mg/dl [normal range ,1.1 mg/dl], creatinine clearance 35 ml/min [normal value 75-125 ml/min], urea 69 mg/dl [normal range 14-43 mg/dl], uric acid 7.5 mg/dl [normal range 3.5-7 mg/dl], and proteinuria of 9.6 g/24 h). Liver en-were elevated. Serum ferritin was strongly increased to 1770 ng/ml (normal range 34-310 ng/ml), and iron was slightly decreased to 28 mg/dl (normal range 40-160 mg/dl). Peripheral blood counts showed anemia (hemoglobin 8.3 mg/dl [normal range 12-16 mg/dl]), slight leukopenia (3900/ml [normal range 4000-10,000/ml]), and thrombopenia (99,000/ml [normal range 150,000-400,000/ml]). The number of CD4 + T cells was decreased to 174 cells/ml. Quantitative PCR analyses demonstrated low HIV-1 viremia (790 copies/ml), a low cytomegalovirus viremia (6 copies/10 5 cells), and shedding of BK virus in the urine (4400 copies/ml). PCR analyses yielded negative results for hepatitis C virus in serum and for adenovirus and John Cunningham virus in the urine. All other laboratory parameters including the complement factors C3 and C4, antinuclear antibodies, cryoglobulins, anti-dsDNA antibodies, ...

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“…The association between syphilis and kidney disease has been reported in congenital syphilis, 16,17 subclinical acquired syphilis, 18 and latent, 10,12 secondary, 2,3,19 and tertiary syphilis. 4,5 Furthermore, a diagnosis of idiopathic membranous nephropathy should lead to evaluation for syphilis in patients presenting risk factors. Accepted criteria for diagnosing a luetic (syphilitic) glomerulopathy include: positive syphilis serology in a patient with nephrotic syndrome and either spontaneous remission or complete recovery after penicillin therapy, or the presence of antitreponemal antibody and/or treponemal antigen in the glomerular deposits.…”

Section: Discussionmentioning

confidence: 99%

“…Intramuscular penicillin G benzathine (2.4 million units) is the treatment of choice but can be administered as either one dose or a series of three weekly injections. [2][3][4][5][6][7] We chose to treat our patient with the three weekly injections since we felt that kidney involvement suggested a more advanced stage of syphilitic infection. Two months after initiating therapy the proteinuria resolved and both serum triglycerides and albumin returned to normal…”

Section: Case Reportmentioning

confidence: 99%

Syphilis and Kidney Disease: A Case Report and Review of Literature

Hannawi

Raghavan

2012

Nephrology Research & Reviews

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There has been a resurgence in the number of incident cases of syphilis in the United States. Syphilis can affect the kidney and usually causes a glomerular lesion with variable amounts of proteinuria. We present a case of a 24-year old African-American male who presented with both membranous glomerulonephritis and secondary syphilis. His kidney disease resolved after a course of penicillin. Recognizing the association of syphilis and proteinuria is important since antibiotic therapy generally results in complete recovery of the associated nephropathy

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Renal disease in AIDS: it is not always HIVAN

Cited by 9 publications

References 21 publications

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

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

Renal Leishmaniasis as Unusual Cause of Nephrotic Syndrome in an HIV Patient

Syphilis and Kidney Disease: A Case Report and Review of Literature

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