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Diagnosis: HIV Associated Nephropathy
HIV-associated nephropathy (HIVAN) is a collapsing glomerulopathy accompanied by microcystic tubular dilatation and interstitial inflammation (logically in an HIV-positive patient) (Laurinavicius A, et al. Collapsing glomerulopathy in HIV and non-HIV patients: a clinicopathological and follow-up study. Kidney Int. 1999;56:2203-13 [PubMed link]).
The pathogenesis is hypothesized to involve infection of epithelial cells by HIV, expression of HIV genes within infected kidney cells, and host factors, including genetic susceptibility. More than 90% of patients with HIVAN are African descent (Lescure FX, et al. HIV-associated kidney glomerular diseases: changes with time and HAART. Nephrol Dial Transplant. 2012;27(6):2349-55. [PubMed link]).
The prognosis in patients with HIVAN is poor, even if treated with HAART.
See the chapter: Focal Segmental Glomerulosclerosis of our Tutorial.
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References
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Kumar N, Perazella MA. Differentiating HIV-associated nephropathy from antiretroviral drug-induced nephropathy: a clinical challenge. Curr HIV/AIDS Rep. 2014 ;11(3):202-11 [PubMed link]
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Waheed S, Atta MG. Predictors of HIV-associated nephropathy. Expert Rev Anti Infect Ther. 2014;12(5):555-63. [PubMed link]
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Ahmed S, Truong L, Eknoyan G, Workeneh B. Evolving spectrum of HIV-associated nephropathy. Nephron Clin Pract. 2012;121(3-4):c131-5. [PubMed link]
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Lescure FX, Flateau C, Pacanowski J, Brocheriou I, Rondeau E, Girard PM, Ronco P, Pialoux G, Plaisier E. HIV-associated kidney glomerular diseases: changes with time and HAART. Nephrol Dial Transplant. 2012;27(6):2349-55. [PubMed link]
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Laurinavicius A, Hurwitz S, Rennke HG. Collapsing glomerulopathy in HIV and non-HIV patients: a clinicopathological and follow-up study. Kidney Int. 1999;56:2203-13: [PubMed link]