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Chronic Renal Disease Associated with HIV Infection

Benedict M Holden1, M Gary Brook

  • 1Patrick Clements Clinic, Department of GUM/HIV, Central Middlesex Hospital, London, United Kingdom.

Saudi Journal of Kidney Diseases and Transplantation : an Official Publication of the Saudi Center for Organ Transplantation, Saudi Arabia
|January 23, 2008
PubMed

Insights

HIV-associated nephropathy (HIVAN) is the most common cause of renal failure in HIV-infected patients. Early diagnosis and treatment with highly active anti-retroviral therapy can lead to full recovery of kidney function.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Virology

Background:

  • HIV-associated nephropathy (HIVAN) is a significant cause of renal failure in HIV-infected individuals.
  • It disproportionately affects Black African and Afro-Caribbean populations.
  • The advent of highly active anti-retroviral therapy (HAART) has altered the landscape of renal disease in HIV patients.

Purpose of the Study:

  • To review the current understanding of the etiology, pathology, diagnosis, and treatment of HIVAN.
  • To examine the renal effects of anti-retroviral agents and their pharmacokinetics.
  • To highlight the impact of HAART on renal disease patterns in HIV infection.

Main Methods:

  • A comprehensive Medline search was conducted from 1989 to March 2002.
  • Keywords included "HIV", "nephropathy", "renal", and "kidney".
  • Searches were also performed for anti-retroviral agents combined with "renal" or "kidney" and MeSH heading "pharmacokinetics".

Main Results:

  • HIVAN remains the most frequent cause of renal failure in HIV-infected patients.
  • Rapidly progressing renal failure due to HIVAN is a common complication, particularly in specific ethnic groups.
  • Immune reconstitution following HAART has led to changes in renal disease patterns.

Conclusions:

  • HIVAN is a treatable condition.
  • Early diagnosis and prompt treatment with HAART are crucial for potential full recovery of renal function.
  • Active screening for HIVAN in HIV-infected patients is recommended to ensure they benefit from available therapies.

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