title: HIV-associated immune complex kidney disease.
abstract: The introduction in the late 20(th) century of combination antiretroviral therapy (cART) to treat patients infected with HIV has changed the natural history of the disease from an acute illness that rapidly culminates in death, to a chronic condition that can be managed with medications. Over the past decade the epidemiology of kidney disease in US patients infected with HIV has changed, perhaps because of the increased availability and use of cART. Patients with HIV infection exhibit unique immunologic characteristics, including immunodeficiency and dysregulation of immunoglobulin synthetic responses and T-cell function, which can result in glomerular immune complex deposition and subsequent kidney injury. This Review examines the differential diagnoses of HIV-associated immune complex kidney diseases (HIVICD), and discusses the clinical manifestations and mechanisms underlying their development. We address the issues associated with treatment, clinical outcomes, and research needs to enhance our ability to diagnose and optimally treat patients with HIVICD.
authors.affiliation: Division of Renal Diseases and Hypertension, Department of Medicine, George Washington University, 2150 Pennsylvania Avenue, NW #3-438, Washington, District of Columbia 20037, USA.
authors.forename: Ehsan
authors.initials: E
authors.lastname: Nobakht
authors.affiliation: Division of Renal Diseases and Hypertension, Department of Medicine, George Washington University, 2150 Pennsylvania Avenue, NW #3-438, Washington, District of Columbia 20037, USA.
authors.forename: Scott D
authors.initials: SD
authors.lastname: Cohen
authors.affiliation: Department of Pathology, Johns Hopkins University School of Medicine, 720 Rutland Avenue, Baltimore, Maryland 21287, USA.
authors.forename: Avi Z
authors.initials: AZ
authors.lastname: Rosenberg
authors.affiliation: Division of Renal Diseases and Hypertension, Department of Medicine, George Washington University, 2150 Pennsylvania Avenue, NW #3-438, Washington, District of Columbia 20037, USA.
authors.forename: Paul L
authors.initials: PL
authors.lastname: Kimmel
mesh_terms: D016263:AIDS-Associated Nephropathy / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D000818:Animals; D000936:Antigen-Antibody Complex / Q000276:immunology*; D000075944:Apolipoprotein L1; D001053:Apolipoproteins / Q000235:genetics; D004195:Disease Models, Animal; D005921:Glomerulonephritis / Q000209:etiology; D006801:Humans; D008075:Lipoproteins, HDL / Q000235:genetics
chemical_list: C108666:APOL1 protein, human; D000936:Antigen-Antibody Complex; D000075944:Apolipoprotein L1; D001053:Apolipoproteins; D008075:Lipoproteins, HDL