Role of HIV-1 DNA levels as clinical marker of HIV-1-associated nephropathies.
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.
Izzedine
Hassane
H
Department of Nephrology, Pitie-Salpetiere Hospital, Paris, France. hassan.izzedine@psl.aphp.fr
Acharya
Veena
V
Wirden
Marc
M
Cluzel
Philippe
P
Sene
Damien
D
Lucas
Gregory M
GM
Baumelou
Alain
A
Atta
Mohamed G
MG
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
D015415:Biomarkers; D004279:DNA, Viral