Abstract
Background: Renal disease is an important cause of morbidity and mortality in populations with HIV infection. Widespread use of combination antiretroviral therapy has altered the spectrum of renal disease. Studies among the HIV affected population in India are few. Objectives: The study was carried out to determine the various histopathological lesions in HIV patients with renal dysfunction, undergoing a renal biopsy, and to establish the clinico-pathological correlation. Patients and Methods: Thirty HIV-positive patients, diagnosed by enzyme-linked immunosorbent assay (ELISA) method according to the National AIDS Control Organization (NACO) guidelines, undergoing a renal biopsy for renal dysfunction were studied. Descriptive statistics were applied. Results: Rather than the classic human immunodeficiency virus associated nephropathy (HIVAN) or a few prototypical lesions, the cases were spread across the entire spectrum of glomerular and tubulointerstitial pathologies described in the HIV population. A higher proportion of diabetic nephropathy, IgA nephropathy and chronic interstitial nephritis were encountered in the present study. Conclusions: In the present scenario of increasing incidence of HIV infection, studying its various manifestations are relevant. As none of the clinical or laboratory variables are found to predict glomerular versus non-glomerular lesions on biopsy, a renal biopsy is indicated in renal dysfunction associated with HIV, to make an accurate diagnosis and for therapy.
Highlights
Renal disease is an important cause of morbidity and mortality in populations with Human immunodeficiency virus (HIV) infection
Implication for health policy/practice/research/medical education: HIV-related kidney disease has become a relatively common cause of end-stage renal disease (ESRD) requiring dialysis, and kidney disease may be associated with progression to acquired immune deficiency syndrome (AIDS) and death
For patients with declining renal function, knowledge of their renal histology obtained by renal biopsy would provide powerful prognostic information that would alter the therapy in appropriate clinical circumstances
Summary
Renal disease is an important cause of morbidity and mortality in populations with HIV infection. Objectives: The study was carried out to determine the various histopathological lesions in HIV patients with renal dysfunction, undergoing a renal biopsy, and to establish the clinico-pathological correlation. Results: Rather than the classic human immunodeficiency virus associated nephropathy (HIVAN) or a few prototypical lesions, the cases were spread across the entire spectrum of glomerular and tubulointerstitial pathologies described in the HIV population. Human immunodeficiency virus (HIV) infection and the acquired immune deficiency syndrome (AIDS) has appeared as a multi-system disease which involves almost all organs of the body [1]. The kidneys are increasingly affected by a variety of disease processes Opportunistic infections including those caused by atypical organisms, malignancies such as lymphoma and Kaposi sarcoma, and disease processes specific to HIV infection such as
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