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HIV associated renal disease: a pilot study from north India
Vijay Gupta1, Sanjay Gupta, Sanjeev Sinha
1Department of Nephrology , All India Institute of Medical Sciences, New Delhi, India.
The Indian Journal of Medical Research
|June 14, 2013
Summary
Renal involvement affects 17.3% of HIV/AIDS patients in North India. Antiretroviral treatment (ART) may offer kidney protection, with collapsing FSGS noted, but not classical HIV nephropathy.
Area of Science:
- Nephrology
- Infectious Diseases
- Public Health
Background:
- Renal involvement is a known complication of Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS).
- Data on the spectrum of renal diseases in HIV/AIDS patients in India are limited.
- This study aimed to investigate renal disease prevalence in North Indian HIV/AIDS patients.
Purpose of the Study:
- To determine the prevalence and spectrum of renal diseases in HIV-positive individuals in North India.
- To compare renal involvement in treatment-naïve patients versus those on antiretroviral treatment (ART).
Main Methods:
- Prospective screening of HIV-positive adults (>18 years) for renal involvement (serum creatinine >1.5 mg% and/or proteinuria >500 mg/day).
- Follow-up of patients with renal involvement, including kidney biopsy for indicated cases.
- Categorization into treatment-naïve and ART groups.
Main Results:
- Out of 526 screened patients, 91 (17.3%) had renal involvement.
- Renal involvement was higher in treatment-naïve patients (18.9%) compared to those on ART (12.7%).
- Kidney biopsies (n=26) revealed mesangioproliferative glomerulonephritis (10/26) as the most common diagnosis; collapsing FSGS was observed in 2 patients.
Conclusions:
- Renal involvement is common in HIV-positive individuals in North India.
- Antiretroviral treatment (ART) may have a renoprotective effect, indicated by lower renal involvement rates.
- Collapsing FSGS appears not to be rare in this population, contrasting with the absence of classical HIV-associated nephropathy.
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