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Pharmacotherapy for human immunodeficiency virus-associated nephropathy
Scott D Pope1, Melissa D Johnson, D Byron May
1Department of Pharmacy, Carolinas Medical Center, Carolinas HealthCare System, Charlotte, NC 28203, and the Department of Pharmacy, Duke University Medical Center, Durham, North Carolina, USA. scott.pope@carolinas.org
Pharmacotherapy
|November 25, 2005
Summary
HIV-associated nephropathy (HIVAN) affects 10% of adult HIV patients, causing renal failure. While treatments like antiretroviral therapy show promise, optimal strategies require further study.
Area of Science:
- Nephrology
- Infectious Diseases
- Public Health
Background:
- HIV-associated nephropathy (HIVAN) affects approximately 10% of adult HIV patients.
- HIVAN is a significant cause of renal failure, particularly in individuals of African descent.
- The condition is characterized by renal filtration system damage, elevated creatinine, proteinuria, and potential end-stage renal disease (ESRD) with high mortality.
Purpose of the Study:
- To review the current understanding of HIV-associated nephropathy (HIVAN).
- To explore potential treatment strategies for HIVAN.
- To highlight the need for further research into effective HIVAN management.
Main Methods:
- Review of existing clinical trials and case reports on HIVAN treatments.
- Analysis of reported outcomes for combination antiretroviral therapy, ACE inhibitors, and corticosteroids.
- Assessment of limited clinical experience with cyclosporine in HIVAN management.
Main Results:
- Small trials and case reports suggest potential benefits from combination antiretroviral therapy, ACE inhibitors, and corticosteroids.
- These treatments may be associated with improvements in serum creatinine and proteinuria.
- Clinical experience with cyclosporine for HIVAN is limited.
Conclusions:
- The optimal treatment strategy for HIVAN remains unclear due to limited evidence.
- Antiretroviral therapy, ACE inhibitors, and corticosteroids show potential but require further investigation.
- Close patient monitoring is essential when managing HIVAN.