Chronic Renal Disease Associated with HIV Infection

To describe current knowledge on the etiology, pathology, diagnosis and treatment of HIV-associated nephropathy (HIVAN), a Medline search was performed from 1989 to March 2002 using the key words, "HIV", "nephropathy", "renal" and "kidney". A further search was performed for each of the currently licensed anti-retroviral agents linked to key words "renal" or "kidney" and also using the MeSH heading "pharmacokinetics". Following the introduction of highly active anti-retroviral therapy with subsequent immune reconstitution different patterns of renal disease have occurred. In patients suffering from HIV-infection, the most common cause of renal failure is HIVAN. This rapidly progressing renal failure is the commonest complication of HIV in black African and Afro-Caribbean patients. Fortunately, if patients are diagnosed and treated soon enough with highly active anti-retroviral therapy, the evidence suggests that full recovery of renal function is possible. In conclusion, since HIVAN is a treatable condition, it should be actively sought in HIV-infected patients if they are to receive the benefits of therapy.