[Nephropathies and HIV virus infection. Anatamo-clinical study]

We report 16 patients with HIV1 infection with biopsy-proven renal involvement. Nine patients were caucasians and seven were blacks. There were 11 patients at stage II and 5 at stage IV of the HIV1 infection. Three patterns of histologic lesions were found: 6 patients, all blacks, with nephrotic syndrome and/or renal insufficiency had focal and segmental glomerulosclerosis (FSGS) with tubulo-interstitial lesions. In contrast, 6 patients, all caucasians, had various types of glomerulonephritis characterized by immunoglobulin and complement deposits; 3 of them were membranoproliferative glomerulonephritis (MPGN). The four remaining patients had predominant tubulointerstitial lesions. In three patients who had FSGS, treatment by AZT induced temporary improvement of renal function and hemodialysis could be interrupted for a few months. The cure of infectious foci was followed by improvement in renal signs in two out of the 3 MPGN patients. Our study further underlines: 1) the importance of genetic/racial factors in the occurrence of HIV1-associated glomerular lesions and 2) the relatively frequent occurrence of MPGN related to bacterial infections in caucasian patients.