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Updates on HIV and Kidney Disease

C Elena Cervantes1, Mohamed G Atta2

  • 1Department of Medicine, Division of Nephrology, Johns Hopkins University, 1830 E. Monument Street, Suite 416, Baltimore, MD, 21218, USA.

Current HIV/AIDS Reports
|January 25, 2023
PubMed

Insights

HIV infection is now a chronic condition, shifting focus to non-HIV kidney disease risks and antiretroviral therapy's impact. This review covers risk factors, diagnostics, pathology, and nephrotoxicity in HIV-associated kidney disease.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Genetics

Background:

  • Antiretroviral therapy has transformed HIV infection into a chronic condition in developed nations.
  • Understanding of non-HIV-driven kidney disease risk factors, including APOL1 variants, has advanced.
  • The study of HIV-associated kidney disease now emphasizes traditional chronic kidney disease (CKD) risks and antiretroviral treatment (ART) nephrotoxicity.

Purpose of the Study:

  • To review current knowledge on risk factors contributing to HIV-associated kidney disease.
  • To explore advancements in diagnostic tools for kidney disease in HIV-positive individuals.
  • To examine kidney pathology and antiretroviral therapy-associated nephrotoxicity in the context of chronic HIV infection.

Main Methods:

  • Comprehensive literature review of studies on HIV-associated kidney disease.
  • Analysis of recent findings on genetic (e.g., APOL1) and environmental risk factors.
  • Evaluation of diagnostic strategies and pathological findings in HIV-positive patients with kidney disease.

Main Results:

  • Non-HIV-related factors are increasingly recognized as significant contributors to kidney disease in HIV patients.
  • Traditional CKD risk factors and ART-induced nephrotoxicity are critical considerations.
  • Specific genetic predispositions, like APOL1 risk variants, play a role in HIV-associated kidney disease development.

Conclusions:

  • The management of kidney disease in HIV-positive individuals requires a multifaceted approach.
  • Integrating assessment of traditional CKD risks, genetic factors, and ART-related effects is crucial.
  • Further research is needed to refine diagnostic and therapeutic strategies for HIV-associated kidney disease.
Abstract

Keywords:
Antiretroviral therapyHIV-associated kidney diseaseHIVANImmune complex kidney disease in the setting of HIVInterstitial nephritis

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