Nephropathy associated with infection by human immunodeficiency virus: a report on 11 cases including 6 treated with zidovudine.
The human immunodeficiency virus (HIV) was recently suggested to be involved in generating kidney lesions in HIV-associated nephropathy (HIVN). The possibility that antiretroviral agents can slow down the usually explosive evolution of HIVN to end-stage renal failure (ESRF) has not been studied in many of the series of cases published. The present work is a retrospective analysis of 11 patients with histologically proven HIVN, 6 of whom were treated with zidovudine. Seven patients (group 1) either required dialysis at the outset, when HIVN was diagnosed, or progressed very fast to ESRF within 15-45 days. Two patients of this group were treated with zidovudine, but it had no effect on kidney function. In the remaining 4 patients (group 2), HIVN progressed more slowly than in group 1. All 4 patients were treated with zidovudine at an earlier stage of the disease than ESRF. Only 1 deteriorated to ESRF in 9 months. The 3 others, who did not have ESRF, were followed up for 13, 10 and 32 months, respectively. Although this is a preliminary study, its results do suggest that zidovudine can slow down the evolution of HIVN to ESRF. They highlight the need to screen HIV-positive patients regularly for proteinuria, in order to detect HIVN by renal biopsies at an early stage of renal lesion formation.
Michel
C
C
Service de Néphrologie, Hôpital Tenon, Paris, France.
Dosquet
P
P
Ronco
P
P
Mougenot
B
B
Viron
B
B
Mignon
F
F
D016263:AIDS-Associated Nephropathy / Q000188:drug therapy / Q000473:pathology*; D000328:Adult; D000368:Aged; D001706:Biopsy; D044383:Black People; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D015215:Zidovudine / Q000627:therapeutic use*
D015215:Zidovudine