Human immunodeficiency virus-associated nephropathy.
Human immunodeficiency virus-associated nephropathy (HIVAN) is characterized by high-grade proteinuria and rapid progression to end-stage renal disease (ESRD). Despite the large numbers of HIV-infected cases in Asian countries, data on HIVAN in this area are limited. We report a 54-year-old Taiwanese man with HIVAN who presented with cytomegalovirus retinitis, renal insufficiency (serum creatinine, 3.8 mg/dL) and nephrotic range proteinuria with a daily protein loss of 10.8 g. Despite highly active antiretroviral therapy (HAART) for 31 months, renal failure developed requiring maintenance hemodialysis. Renal biopsy showed collapsing focal segmental glomerular sclerosis, podocyte proliferation and tubulointerstitial nephritis with mononuclear cell infiltration. These features were compatible with HIVAN. Although hemodialysis was instituted, he died 2 months later due to nosocomial pneumonia complicated with multiple organ failure. In summary, this case of HIVAN in a Taiwanese patient shows that the condition may progress to ESRD despite successful viral suppression with HAART.
Lai
Chun-Fu
CF
Department of Internal Medicine, Far Eastern Memorial Hospital, Taipei, Taiwan.
Huang
Jenq-Wen
JW
Lin
Wei-Chou
WC
Hung
Chien-Ching
CC
Chu
Tzong-Shinn
TS
D016263:AIDS-Associated Nephropathy / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D023241:Antiretroviral Therapy, Highly Active; D006801:Humans; D007668:Kidney / Q000473:pathology; D007676:Kidney Failure, Chronic / Q000209:etiology; D008297:Male; D008875:Middle Aged