title: Role of HIV-1 DNA levels as clinical marker of HIV-1-associated nephropathies.
abstract: BACKGROUND
  HIV-associated nephropathy (HIVAN) is usually diagnosed in virologically uncontrolled infected patients. However, HIVAN can occur in some cases with undetectable HIV-1 RNA levels. We suggested that intracellular HIV-1 proviral DNA load can be used as a marker in this particular patient population.
  
  
  METHODS
  Renal tissue HIV-1 proviral DNA, peripheral blood mononuclear cells (PBMCs) HIV-1 proviral DNA, plasma HIV-1 RNA and peripheral blood CD4-positive lymphocyte counts were quantified and assessed in 100 HIV-1-infected individuals (49 with undetectable HIV-1 RNA level viraemia) who underwent a kidney biopsy for renal abnormalities in a prospective study.
  
  
  RESULTS
  A proviral DNA load was detected in patients with HIV-1-associated nephropathy with a negative plasma viral RNA load. None of the patients with a proviral DNA load of <10 copies/1.5×10(5) PBMCs had HIVAN. In renal tissue, proviral DNA load was detected in all patients with HIVAN.
  
  
  CONCLUSIONS
  PBMC HIV-1 proviral DNA load is potentially the optimal clinical marker to exclude the diagnosis of HIVAN. On the other hand, cellular incorporation of HIV-1 within the kidney is a requisite for the development of this disorder.
authors.affiliation: Department of Nephrology, Pitie-Salpetiere Hospital, Paris, France. hassan.izzedine@psl.aphp.fr
authors.forename: Hassane
authors.initials: H
authors.lastname: Izzedine
authors.forename: Veena
authors.initials: V
authors.lastname: Acharya
authors.forename: Marc
authors.initials: M
authors.lastname: Wirden
authors.forename: Philippe
authors.initials: P
authors.lastname: Cluzel
authors.forename: Damien
authors.initials: D
authors.lastname: Sene
authors.forename: Gregory M
authors.initials: GM
authors.lastname: Lucas
authors.forename: Alain
authors.initials: A
authors.lastname: Baumelou
authors.forename: Mohamed G
authors.initials: MG
authors.lastname: Atta
mesh_terms: D016263:AIDS-Associated Nephropathy / Q000175:diagnosis* / Q000821:virology*; D000328:Adult; D015415:Biomarkers / Q000032:analysis; D001706:Biopsy; D004279:DNA, Viral / Q000032:analysis*; D005260:Female; D015497:HIV-1 / Q000302:isolation & purification*; D006801:Humans; D007668:Kidney / Q000473:pathology / Q000821:virology*; D007963:Leukocytes, Mononuclear / Q000821:virology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011533:Proviruses; D019562:Viral Load
chemical_list: D015415:Biomarkers; D004279:DNA, Viral