Renal lesions associated with AIDS--an autopsy study

Area of Science:

• Nephrology
• Infectious Diseases
• Pathology

Background:

• Acquired Immunodeficiency Syndrome (AIDS) and Human Immunodeficiency Virus (HIV) infection can lead to various renal pathologies.
• Understanding the spectrum of kidney diseases in these patients is crucial for diagnosis and management.

Purpose of the Study:

• To investigate the glomerular, interstitial, and vascular pathology in the kidneys of patients with HIV infection and AIDS.
• To identify the prevalence of different renal lesions and their etiological factors in this cohort.

Main Methods:

• Histopathological examination of kidney tissues from 55 cases (20 HIV-infected, 35 with AIDS).
• Utilized routine Haematoxylin and Eosin stains alongside special stains including Periodic Acid-Schiff (PAS), Periodic Acid-Schiff Methenamine (PASM), Gomori Methenamine Silver (GMS), Ziehl-Neelsen (ZN), Mucicarmine, and Congo red.

Main Results:

• Infective etiologies were identified in 68.6% of AIDS cases, with tuberculosis (48.5%) being the most frequent, followed by fungal infections (14.4%) and Cytomegalovirus (CMV) infection (5.7%).
• Other observed renal lesions included amyloidosis and tubular calcinosis.
• HIV-associated nephropathy (HIVAN) was not detected in any of the studied cases.
• Intravenous drug abuse, a known risk factor for HIVAN, was not identified as a risk factor in this patient group.

Conclusions:

• Infectious agents, particularly tuberculosis, are significant causes of kidney pathology in patients with AIDS in this study cohort.
• The absence of HIV-associated nephropathy may be linked to the lack of intravenous drug abuse among the studied patients.
• Renal pathology in HIV/AIDS is diverse, emphasizing the need for comprehensive histopathological evaluation.