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Chronic, Acute, and Reactivated HIV Infection in Humanized Immunodeficient Mouse Models
Published on: December 3, 2019
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HIV and chronic kidney disease.
Saraladevi Naicker1, Sadaf Rahmanian, Jeffrey B Kopp
1Division of Nephrology, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa, and Kidney Disease Section, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA.
Clinical Nephrology
|March 1, 2015
Summary
Chronic kidney disease (CKD) is a significant complication of HIV infection. Early detection and access to antiretroviral therapy (ART) improve kidney health and survival rates in HIV patients.
Area of Science:
- Nephrology
- Infectious Diseases
- Genetics
Background:
- Chronic kidney disease (CKD) affects 3.5-48.5% of individuals with HIV infection.
- Kidney disease in HIV is multifactorial, involving the virus, host genetics (e.g., APOL1 variants), and co-infections.
- HIV-associated nephropathy (HIVAN) and HIV-immune complex disease are key renal manifestations.
Purpose of the Study:
- To review the epidemiology, pathogenesis, and management of CKD in HIV-infected individuals.
- To highlight the impact of antiretroviral therapy (ART) on HIV-associated kidney disease.
- To discuss factors influencing CKD progression and renal survival in the context of HIV.
Main Methods:
- Literature review of studies on HIV-associated nephropathy and CKD.
- Analysis of factors contributing to HIV-CKD, including genetic predisposition and co-morbidities.
- Evaluation of the role of ART, dialysis, and kidney transplantation in HIV-CKD management.
Main Results:
- ART has reduced HIVAN incidence but focal segmental glomerulosclerosis is increasing.
- ART initiation improves kidney function in HIV-CKD patients.
- High-grade proteinuria, reduced eGFR, co-infections, and glomerulosclerosis predict worse renal outcomes.
Conclusions:
- CKD is a complex complication of HIV requiring multifactorial management.
- Early screening for kidney disease and prompt ART initiation are crucial for improving outcomes.
- Renal survival is enhanced by renin-angiotensin system blockers and viral suppression.
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