Renal disease and HIV infection: clinical course, treatment outcome, and infection control

The AIDS epidemic is growing worldwide, and projections for the next decade indicate that over 6 million people will develop clinical AIDS, an increase of 10-30 times the number that has been reported to date. AIDS is spreading rapidly among intravenous drug abusers, which is the risk group that is at highest risk for the development of HIV associated nephropathy (HIVAN). This will result in an increase in the number of patients who develop end stage renal disease (ESRD) and require dialysis treatment during the next decade. Survival time for patients with AIDS is improving as new therapies are implemented; the prognosis for patients with AIDS and ESRD also appears to be slightly better, but the natural course of HIV infection in the ESRD patient remains to be defined.