HIV-associated nephropathy

9. HIV-associated nephropathy

The various manifestation of HIV infection causing both acute and chronic renal disease is summarized in Fig. 10.12.2.9.1.

Fig. 10.12.2.9.1 Table showing causes of HIVAN.

Introduction

HIV-associated nephropathy is the leading cause of renal failure in HIV-positive patients and is seen in up to 40% of affected patients. HIVAN is diagnosed in 60% of all renal biopsies performed on HIV patients with renal dysfunction.

Risk factors

Complex immunologic, environmental and genetic factors contribute to the occurrence of HIVAN (Fig. 10.12.2.9.2).

Fig. 10.12.2.9.2 Table showing various factors contributing for the occurrence of HIVAN.

Pathology

The kidneys act as a possible reservoir of the virus with replication in glomerular epithelial cells despite normal serum levels.

Collapsing glomerulopathy is the glomerular abnormality encountered in HIV-associated nephropathy and was initially described as a form of focal segmental glomerulosclerosis.