In-Depth Review of Human Immunodeficiency Virus-Associated Nephropathy
Nitipong Permpalung, Wikrom Chaiwatcharayut, Sira Korpaisarn, Wisit Cheungpasitporn, Daych Chongnarungsin and Edward F. Bischof
DOI : 10.3844/amjsp.2013.82.90
Current Research in Medicine
Volume 4, Issue 1
Human Immunodeficiency Virus (HIV)-Associated Nephropathy (HIVAN) is one of the most important renal complications found in HIV-infected individuals. Morbidity and mortality in this group of patients increases due to End-Stage Renal Disease (ESRD). Classic histological characteristics of HIVAN are collapsing Focal Segmental Glomerulosclerosis (FSGS), microcystic tubular dilation and interstitial inflammation and fibrosis. High prevalence of HIVAN among people of African descent can be explained by host genetic susceptibility, which is associated with several genes on human chromosome 22. HIV can infect renal epithelial cells via unconventional mechanisms and cause changes in multiple host cellular pathways, especially in renal tubular cells and podocytes. Accurate diagnosis of HIVAN relies mainly on renal biopsy. Antiretroviral therapy is the mainstay treatment for HIVAN and current standard guidelines recommend the initiation of Highly Active Antiretroviral Therapy (HAART) in all HIV-infected individuals with HIVAN, regardless of CD4 level. Other possible treatments for HIVAN including steroids, Angiotensin Converting Enzyme (ACE) inhibitors, renal replacement therapy and renal transplantation are reviewed in this chapter.
© 2013 Nitipong Permpalung, Wikrom Chaiwatcharayut, Sira Korpaisarn, Wisit Cheungpasitporn, Daych Chongnarungsin and Edward F. Bischof. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.