title: Prevalence of nephrolithiasis in human immunodeficiency virus infected patients on the highly active antiretroviral therapy.
abstract: OBJECTIVE
  Protease inhibitors, specifically indinavir, have historically been implicated as a cause of nephrolithiasis in the human immunodeficiency virus (HIV) infected patients. There is a paucity of data, however, on stone disease with nonindinavir etiologies since the introduction of highly active antiretroviral therapy (HAART). We sought to describe the prevalence of nephrolithiasis in the HIV population since the use of HAART.
  
  
  METHODS
  We retrospectively reviewed HIV-positive patients currently receiving HAART treatment in whom image proven kidney and/or ureteral urolithiasis developed, between 1998 and 2010. A detailed analysis of patients' current treatment, surgical intervention, and metabolic studies was performed.
  
  
  RESULTS
  A total of 436 HIV-positive patients were included and 46 (11%) patients had nephrolithiasis. Each patient included in this study was receiving nonindinavir-based antiretroviral therapy. There were 41 men of whom 36 were Caucasian. Eleven (24%) patients underwent 24-hour urine collections with 11 metabolic abnormalities identified. Stone analysis was available for seven patients (four calcium oxalate monohydrate, one cystine, one uric acid, and one atazanavir).
  
  
  CONCLUSIONS
  We report the largest series of nephrolithiasis in an HIV population since the introduction of HAART and highlight not only the similar prevalence of nephrolithiasis to the non-HIV population but also the lack of consistent comprehensive metabolic evaluations in HIV patients with recurrent nephrolithiasis.
authors.affiliation: Division of Urology, Department of Surgery, University of California San Diego Health Care System, San Diego, California 92103, USA. RLsur@ucsd.edu
authors.forename: Omer A
authors.initials: OA
authors.lastname: Raheem
authors.forename: Hossein S
authors.initials: HS
authors.lastname: Mirheydar
authors.forename: Kerrin
authors.initials: K
authors.lastname: Palazzi
authors.forename: Marianne
authors.initials: M
authors.lastname: Chenoweth
authors.forename: Charles
authors.initials: C
authors.lastname: Lakin
authors.forename: Roger L
authors.initials: RL
authors.lastname: Sur
mesh_terms: D000328:Adult; D000368:Aged; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D002140:California / Q000453:epidemiology; D015331:Cohort Studies; D003710:Demography; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D053040:Nephrolithiasis / Q000453:epidemiology* / Q000209:etiology*; D015995:Prevalence