Absence of HIV-associated nephropathy in Ethiopians.
BACKGROUND
Population-based epidemiological surveys in several countries have shown approximately 10- to 15-fold increased susceptibility to human immunodeficiency virus (HIV)-associated nephropathy (HIVAN) for populations of recent African ancestry. Accordingly, we sought to determine whether a similar or different pattern of susceptibility was evident among Ethiopians followed up in an HIV clinic in Israel.


METHODS
One hundred seventy-six consecutive patients (126 Ethiopians, 50 non-Ethiopian Israelis) followed up at the HIV clinic of Rambam Medical Center in northern Israel were examined for the presence of proteinuria and/or decreased glomerular filtration rate. HIV viral load, CD4 count, and treatment modality also were determined.


RESULTS
Overall, 73% of patients were treated with highly active antiretroviral therapy, and there was no difference between Ethiopians and non-Ethiopian Israelis in this regard. Mean CD4 count in Ethiopians was 288 +/- 140/microL, significantly less than the corresponding CD4 count of 398 +/- 190/microL for non-Ethiopian Israelis. Mean viral loads were greater in Ethiopians compared with non-Ethiopian Israelis. None of 176 HIV-infected patients fulfilled clinical criteria for HIVAN as delineated in this study.


CONCLUSIONS
HIV-infected individuals of Ethiopian descent have a level of susceptibility to HIVAN similar to that of non-Ethiopian Israelis, which is strikingly less than that reported for other populations for recent African ancestry. This does not appear to be attributable to differences in HIV infection control or viral subtype and most likely represents population-based differences in host genetic factors. This finding emphasizes the importance of avoiding generalizations with respect to phylogeographic ancestry in disease-susceptibility studies.
Behar
Doron M
DM
Department of Critical Care Medicine, The Bruce Rappaport Faculty of Medicine and Research Institute, Haifa, Israel.
Shlush
Liran I
LI
Maor
Carcom
C
Lorber
Margalit
M
Skorecki
Karl
K
D016263:AIDS-Associated Nephropathy / Q000453:epidemiology* / Q000209:etiology / Q000235:genetics; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D044383:Black People / Q000235:genetics*; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D005002:Ethiopia / Q000208:ethnology; D005260:Female; D040961:Genetic Drift; D020022:Genetic Predisposition to Disease; D015658:HIV Infections / Q000188:drug therapy / Q000276:immunology / Q000378:metabolism; D015497:HIV-1; D006801:Humans; D007557:Israel / Q000453:epidemiology; D007585:Jews / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D019562:Viral Load
D019380:Anti-HIV Agents