HIV-associated nephropathy (HIVAN)
- Christina M Wyatt, MD
Christina M Wyatt, MD
- Associate Professor
- Icahn School of Medicine at Mount Sinai
- Paul E Klotman, MD
Paul E Klotman, MD
- President, CEO, and Executive Dean
- Baylor College of Medicine
Human immunodeficiency virus (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".)
HIVAN, the classic kidney disease associated with HIV infection, was first described in 1984 as a complication of acquired immune deficiency syndrome (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 segmental glomerulosclerosis (FSGS) (picture 1), accompanied by 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-positive 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 "Kidney 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 cellsTo continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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- CLINICAL MANIFESTATIONS
- Differential diagnosis
- TREATMENT AND FOLLOW-UP
- Overview of medical therapy
- - ART and HIVAN
- - Renin-angiotensin system inhibition
- - Glucocorticoids
- Routine chronic kidney disease care
- Dialysis and transplantation
- SOCIETY GUIDELINE LINKS
- SUMMARY AND RECOMMENDATIONS