Multiple facets of HIV-associated renal disease

Silva, D.R. da; Gluz, Ivan Cirilo; Kurz, Jeremiah; Thomé, Gustavo Gomes; Zancan, Rafael; Bringhenti, Rafael Nazario; Schaefer, Pedro Guilherme; Santos, Mariane dos; Barros, Elvino; Veronese, Francisco Veríssimo

doi:10.1590/1414-431x20165176

Cited by 13 publications

(16 citation statements)

References 28 publications

(65 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although the two risk alleles were significantly connected to higher odds of HIVAN, APOL1 genotype did not predict confidently this specific histopathology and cannot eliminate the important role of kidney biopsy in the clinical care of HIV-positive blacks who are with proteinuria more than 3.5 mg/24 h urine or unexplained kidney disease [ 38 ]. The findings of Da Silva et al in 2016 also strengthen the importance of renal biopsy in HIV patients with kidney impairment and/or proteinuria [ 27 ].…”

Section: Pathogenesis Of Hivanmentioning

confidence: 87%

“…The main renal pathological lesions of 61 HIV patients were found to be FSGS, mainly the collapsing form HIVAN in 28%, acute interstitial nephritis (AIN) in 26% and immune complex-mediated glomerulonephritis (ICGN) in 25% of the cases in Brazil. Baseline CD4 cell count ≥ 200 cells/mm 3 proved to be a protective factor against CKD (hazard ratio = 0.997; 95% confidence interval (CI): 0.994 - 0.999; P = 0.012) after 24 months follow-up [ 27 ].…”

Section: Pathological Forms Of Hivan In Africamentioning

confidence: 99%

See 1 more Smart Citation

HIV-Associated Nephropathy in Africa: Pathology, Clinical Presentation and Strategy for Prevention

et al. 2018

View full text Add to dashboard Cite

The human immunodeficiency virus (HIV) infection can lead to progressive decline in renal function known as HIV-associated nephropathy (HIVAN). Importantly, individuals of African ancestry are more at risk of developing HIVAN than their European descent counterparts. An in-depth search on Google Scholar, Medline and PubMed was conducted using the terms “HIVAN” and “pathology and clinical presentation”, in addition to “prevalence and risk factors for HIVAN”, with special emphasis on African countries for any articles published between 1990 and 2017. HIVAN is characterized by progressive acute renal failure, proteinuria and enlarged kidneys. A renal biopsy is necessary to establish definitive diagnosis. Risk factors are male gender, low CD4 counts, high viral load and long use of combined antiretroviral medication (cART). There is a wide geographical variation in the prevalence of HIVAN as it ranges from 4.7% to 38% worldwide and little published literature is available about its prevalence in African nations. Microalbuminuria is a common finding in African populations and is significantly associated with severity of HIV disease progression and CD4 count less than 350 cells/µL. Other clinical presentations in African populations include acute kidney injury (AKI), nephrotic syndrome and chronic kidney disease. The main HIV-associated renal pathological lesions were focal segmental glomerulosclerosis, mainly the collapsing form, acute interstitial nephritis (AIN), and immune complex-mediated glomerulonephritis (ICGN). HIV infection-induced transcriptional program in renal tubular epithelial cells as well as genetic factors is incriminated in the pathogenesis of HIVAN. This narrative review discusses the prevalence, presentation, pathogenesis and the management of HIVAN in Africa. In low resource setting countries in Africa, dealing with HIV complications like HIVAN may add more of a burden on the health system (particularly renal units) than HIV medication itself. Therefore, the obvious recommendation is early use of cART in order to decrease risk factors that lead to HIVAN.

show abstract

Section: Pathogenesis Of Hivanmentioning

confidence: 87%

Section: Pathological Forms Of Hivan In Africamentioning

confidence: 99%

HIV-Associated Nephropathy in Africa: Pathology, Clinical Presentation and Strategy for Prevention

et al. 2018

View full text Add to dashboard Cite

show abstract

“…The goal of antiretroviral therapy is to suppress viral load and maintain high levels of CD4 + T lymphocytes. In a cohort of 61 HIV patients treated at a hospital in southern Brazil from 2004 to 2014, who underwent renal biopsy due to renal complications (excluding those undergoing transplantation and/ or dialysis treatment) It was found that the CD4 + T cell count ≥200/mm² compared to those with CD4 + T cells <200 cells/mm² over an average period of 25 months, renal function remained more preserved, being a protective factor against the terminal renal disease or death (15) .…”

Section: Discussionmentioning

confidence: 99%

“…The persistent suppression of viral load favored by the introduction of new drugs has provided a decrease in renal cholinergic disease and an improvement in renal function, but some anti-retroviral drugs such as tenofovir have been constantly associated with toxic effects and renal alterations (3,15,18) , as well as indinavir, cidofovir in events such as tubular damage with clinical picture of Fanconi syndrome, nephrogenic, diabetes insipidus and also renal tubular acidosis (3) .…”

Section: Discussionmentioning

confidence: 99%

Evaluation of renal function in patients with human immunodeficiency virus

Costa¹,

Oliveira²,

Vieira³

et al. 2017

Rev Rene

View full text Add to dashboard Cite

Objective: to evaluate the renal function of patients undergoing antiretroviral therapy. Methods: documentary, analytical and cross-sectional study with 150 Human Immunodeficiency Virus positive patients, using antiretroviral therapy, who had under gone exams of serum creatinine and abnormal urine elements and sediments, the glomerular filtration rate was calculated by the Chronic Kidney Disease Epidemiology Collaboration equation and renal dysfunction was stratified. Results: 11.3% of the participants presented a glomerular filtration rate of less than 90 ml/min/1.73 m². Of these, 8.0% had renal dysfunction stage 2, and 3.3%, in stage 3. The variables, older age and prolonged exposure to antiretroviral therapy were statistically significant for altering renal function. Conclusion: estimates of glomerular filtration rate by means of the Chronic Kidney Disease Epidemiology Collaboration equation proved to be an effective measure of early detection of renal function impairment in people living with Human Immunodeficiency Virus/Acquired immunodeficiency syndrome in the use of antiretroviral therapy. Descriptors: Antiretroviral Therapy, Highly Active; HIV Infections; AIDS-Associated Nephropathy. Objetivo: avaliar a função renal de pacientes em uso de terapia antirretroviral. Métodos: estudo documental, analítico e transversal com 150 pacientes Human Immunodeficiency Virus positivos, em uso de terapia antirretroviral, aos quais se ofertaram exames de creatinina sérica e de elementos e sedimentos anormais da urina, calculou-se a taxa de filtração glomerular estimada pela equação Chronic Kidney Disease Epidemiology Collaboration e estratificou-se a disfunção renal. Resultados: 11,3% dos participantes apresentaram taxa de filtração glomerular inferior a 90 ml/min/1,73m². Desses, 8,0% com disfunção renal estágio 2, e 3,3%, em estágio 3. As variáveis, maior idade e exposição prolongada à terapia antirretroviral, apresentaram significância estatística para alteração da função renal. Conclusão: estimativas da taxa de filtração glomerular por meio da equação Chronic Kidney Disease Epidemiology Collaboration mostrou-se medida efetiva de detecção precoce de alteração da função renal em pessoas vivendo com Human immunodeficiency virus/Acquired immunodeficiency syndrome em uso de terapia antirretroviral.

show abstract

“…The association between the genetic variants of the apolipoprotein 1 (APOL1) and HIVAN has been recognized since 2010, especially among the African population 22 . The classical presentation of HIVAN is defined as collapsing glomerulopathy, with nephrotic proteinuria, tubulointerstitial involvement with dilation and formation of tubular microcysts, interstitial inflammation, and tubular injury, whose manifestations may include hematuria, rapidly progressive kidney failure, and arterial hypertension 6,11,18 . In electronic microscopy, endothelial tubuloreticular inclusions (viral footprints) are highly specific and classical characteristics of HIVAN 11.18 .…”

Section: Hiv-associated Nephropathy (Hivan)mentioning

confidence: 99%

HIV-related nephropathy: new aspects of an old paradigm

Reghine

Foresto

Kirsztajn

2020

Rev. Assoc. Med. Bras.

View full text Add to dashboard Cite

SUMMARY The scenario of infection by the human immunodeficiency virus (HIV) has been undergoing changes in recent years, both in relation to the understanding of HIV infection and regarding the treatments available. As a result, the disease, which before was associated with high morbidity and mortality, is now seen as a chronic disease that can be controlled, regarding both transmission and symptoms. However, even when the virus replication is well controlled, the infected patient remains at high risk of developing renal involvement, either by acute kidney injury not associated with HIV, nephrotoxicity due to antiretroviral drugs, chronic diseases associated with increased survival, or glomerular disease associated to HIV. This review will cover the main aspects of kidney failure associated with HIV.

show abstract

Multiple facets of HIV-associated renal disease

Cited by 13 publications

References 28 publications

HIV-Associated Nephropathy in Africa: Pathology, Clinical Presentation and Strategy for Prevention

HIV-Associated Nephropathy in Africa: Pathology, Clinical Presentation and Strategy for Prevention

Evaluation of renal function in patients with human immunodeficiency virus

HIV-related nephropathy: new aspects of an old paradigm

Contact Info

Product

Resources

About