HIV-associated nephropathy in the era of antiretroviral therapy

被引:44
|
作者
Wyatt, Christina M. [1 ]
Klotman, Paul E. [1 ]
机构
[1] CUNY Mt Sinai Sch Med, Div Nephrol, New York, NY 10029 USA
来源
AMERICAN JOURNAL OF MEDICINE | 2007年 / 120卷 / 06期
关键词
chronic kidney disease; HIV; HIV-associated nephropathy;
D O I
10.1016/j.amjmed.2007.01.025
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
With improved survival in the era of antiretroviral therapy, kidney disease has emerged as an important complication of Human Immunodeficiency Virus (HIV) infection and antiretroviral therapy. The classic kidney disease of HIV infection, HIV-associated nephropathy, occurs almost exclusively in patients of African descent. HIV-associated nephropathy is characterized by collapsing focal segmental glomerulosclerosis with associated tubular dilatation and interstitial inflammation, although the histology may be more subtle in patients receiving antiretroviral therapy. Renal epithelial cells are infected by HIV-1, which results in epithelial cell proliferation and induction of local inflammatory pathways. Even with appropriate therapy, the kidney is a reservoir for HIV-1. Although the widespread introduction of antiretroviral therapy has had a beneficial impact on the epidemiology of HIV-associated nephropathy, the burden of kidney disease is likely to increase as a result of antiretroviral toxicity, reduction in competing mortality risks, and the increasing prevalence of HIV-1 infection in patients at risk for kidney disease. (c) 2007 Elsevier Inc. All rights reserved.
引用
收藏
页码:488 / 492
页数:5
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