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Rapid Screening of HIV Reverse Transcriptase and Integrase Inhibitors
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Differentiating HIV-associated nephropathy from antiretroviral drug-induced nephropathy: a clinical challenge

Neelja Kumar1, Mark A Perazella

  • 1Section of Nephrology, Department of Medicine, Yale University School of Medicine, BB 114, 330 Cedar Street, New Haven, CT, 06520-8029, USA.

Current HIV/AIDS Reports
|June 14, 2014
PubMed

Insights

Combination antiretroviral therapy (cART) benefits HIV patients but can cause kidney disease. Differentiating HIV-associated nephropathy (HIVAN) from cART nephrotoxicity is crucial for effective patient management.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Pharmacology

Background:

  • Combination antiretroviral therapy (cART) has improved outcomes for HIV-infected patients.
  • Kidney disease remains a significant complication in this population.
  • The landscape of renal complications has shifted from HIV-associated nephropathy (HIVAN) to include drug toxicities and comorbidities.

Purpose of the Study:

  • To review HIV-associated nephropathy (HIVAN) and cART-related kidney disease.
  • To discuss clinical and laboratory data for differentiating these conditions.
  • To highlight the role of kidney biopsy in diagnosis.

Main Methods:

  • Literature review of HIVAN and cART nephrotoxicity.
  • Analysis of clinical and laboratory differentiating features.
  • Discussion of diagnostic challenges and the utility of kidney biopsy.

Main Results:

  • Distinguishing HIVAN from cART nephrotoxicity can be challenging.
  • Clinical and laboratory data offer clues but are often insufficient.
  • Kidney biopsy is frequently necessary for definitive diagnosis.

Conclusions:

  • HIVAN and cART nephrotoxicity are important causes of kidney disease in treated HIV patients.
  • Accurate differentiation is essential for appropriate management.
  • Kidney biopsy remains a critical diagnostic tool.

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