Controversies in the pathogenesis of HIV-associated renal diseases.
The two most common HIV-associated renal diseases, HIV-associated nephropathy and HIV immune-complex kidney disease, share the common pathologic finding of hyperplasia within the glomerulus. Podocyte injury is central to the pathogenesis of these diseases; however, the source of the proliferating glomerular epithelial cell remains a topic of debate. Parenchymal injury has been linked to direct infection of renal epithelial cells by HIV-1, although the mechanism of viral entry into this non-lymphoid compartment is unclear. Although transgenic rodent models have provided insight into viral proteins responsible for inducing renal disease, such models have substantial limitations. Rodent HIV-1 models, for instance, cannot replicate all features of immune activation, a process that could have an important role in the pathogenesis of the HIV-associated renal diseases.
Bruggeman
Leslie A
LA
Department of Medicine and Rammelkamp Center for Education and Research, MetroHealth Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH 44109, USA. leslie.bruggeman@case.edu
Nelson
Peter J
PJ
D000818:Animals; D004195:Disease Models, Animal; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D007674:Kidney Diseases / Q000209:etiology* / Q000276:immunology; D051379:Mice; D050199:Podocytes / Q000473:pathology; D051381:Rats