HIV infection has been associated with both acute kidney injury (AKI) and chronic kidney disease (CKD). (See "Overview of kidney disease in HIV-positive patients".)
HIV-associated nephropathy (HIVAN), the classic kidney disease associated with HIV infection, was first described in 1984 as a complication of AIDS [1-3], although HIVAN may also occur in patients with less advanced HIV infection or acute seroconversion [4,5]. Histologically, HIVAN is a collapsing form of focal sclerosing glomerulosclerosis (FSGS) (picture 1), which can be distinguished from idiopathic FSGS by the presence of microcystic tubular dilatation and interstitial inflammation .
Issues related to HIVAN will be discussed in this topic. An overview of kidney disease in patients with HIV infection and discussions of electrolyte abnormalities, dialysis, and transplantation in HIV-infected patients are provided elsewhere. (See "Overview of kidney disease in HIV-positive patients" and "Electrolyte disturbances with HIV infection" and "Human immunodeficiency virus and dialysis" and "Solid organ transplantation in HIV-infected individuals".)
The pathogenesis of HIV-associated nephropathy (HIVAN) is hypothesized to involve several factors:
●Infection of kidney epithelial cells by HIV and expression of HIV genes within infected kidney cells