Acute interstitial nephritis of HIV-positive patients under atazanavir and tenofovir therapy in a retrospective analysis of kidney biopsies.
We performed a retrospective analysis on kidney biopsies of 30 human immunodeficiency virus (HIV)-positive patients. Twenty-two of them received highly active antiretroviral therapy (HAART). Tenofovir containing HAART together with atazanavir, a new protease inhibitor, was administered to three patients. All of them developed acute renal failure. The kidney biopsies of these patients showed an acute interstitial nephritis or a chronic interstitial nephritis with an acute component. Withdrawal of atazanavir and tenofovir resulted in recovery of renal function in all three patients. Acute interstitial nephritis was observed only in 1 of 19 patients without atazanavir or tenofovir treatment. We conclude that acute interstitial nephritis and consecutive acute renal failure is a relevant side effect of atazanavir and tenofovir therapy in HIV-positive patients.
Schmid
Simone
S
Department of Pathology, Institute of Surgical Pathology, University Hospital Zurich, Schmelzbergstrasse 12, CH-8091 Zurich, Switzerland. simone.schmid@usz.ch
Opravil
Milos
M
Moddel
Michael
M
Huber
Milo
M
Pfammatter
Rahel
R
Keusch
Gerald
G
Ambuhl
Patrice
P
Wuthrich
Rudolf P
RP
Moch
Holger
H
Varga
Zsuzsanna
Z
D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000473:pathology; D000225:Adenine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects* / Q000627:therapeutic use; D000069446:Atazanavir Sulfate; D005260:Female; D005455:Fluorescent Antibody Technique; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D007150:Immunohistochemistry; D007668:Kidney / Q000473:pathology; D008297:Male; D008854:Microscopy, Electron; D008875:Middle Aged; D009395:Nephritis, Interstitial / Q000139:chemically induced*; D009842:Oligopeptides / Q000009:adverse effects* / Q000627:therapeutic use; D063065:Organophosphonates / Q000009:adverse effects* / Q000627:therapeutic use; D011725:Pyridines / Q000009:adverse effects* / Q000627:therapeutic use; D012189:Retrospective Studies; D000068698:Tenofovir
D019380:Anti-HIV Agents; D009842:Oligopeptides; D063065:Organophosphonates; D011725:Pyridines; D000069446:Atazanavir Sulfate; D000068698:Tenofovir; D000225:Adenine