Kidney In HIV
HIV infection is associated with
- Focal segmental glomerulosclerosis
- Acute diffuse proliferative glomerulonephritis
- Mesangioproliferative glomerulonephritis, including IgA nephropathy
- MPGN
- Membranous glomerulopathy
HIV associated FSGS:
- High frequency of collapsing variant (collapse and sclerosis of entire glomerular tuft)
- Poor prognosis
Aggressive form/HIV-associated nephropathy (HIVAN) is characterized by :
- HIV infection along with microcystic tubular dilatation
- Interstitial fibrosis.
- ‘classic and most common’ HIV-associated glomerulopathy
- Viral genome has been detected in glomerular and tubular cells.
Renal biopsy reveals
- visceral epithelial cell swelling
- collapse of the glomerular capillary tuft
- severe tubulointerstitial inflammation
- microcystic dilatation of renal tubules.
- The presence of tubuloreticular inclusions and the aggressive clinical course distinguish HIV from idiopathic focal segmental glomerulosclerosis.
- The typical clinical correlates of HIV are severe nephrotic syndrome and rapid progression to ESRD, occurring in weeks to months.
Wegener’s Granulomatosis :
- Necrotizing vasculitis of small arteries and veins together with granuloma formation
- Can be either intravascular or extravascular.
Lung involvement:
- bilateral nodular cavitary infiltrates,
- demonstrate necrotizing granulornatous vasculitis.
- The renal biopsy lesion is that of a pauci-immune necrotizing and crescentic GN.
Minimal Change Disease / (Nil) disease / Lipoid Nephrosis
In association with systemic diseases or drugs major cause are:
- HIV infection
- Hodgkins disease and other Lymphoproliferative malignancies
- Drug induced Interstitial Nephritis
- NSAIDS
- Rifampicin
- Interferon
Exam Question
- Focal segmental GN variant of Glomerulonephritis is associated with AIDS
- HIV associated nephropathy is a type of Collapsing glomerulopathy
- HIV infection is associated with focal segmental glomerulosclerosis, acute diffuse proliferative glomerulonephritis, and mesangioproliferative glomerulonephritis, including IgA nephropathy, MPGN, and membranous glomerulopathy.
- HIV infection, Hodgkins disease, and other Lymphoproliferative malignancies, Drug induced Interstitial Nephritis( NSAIDS ,Rifampicin, Interferon) are the conditions associated with minimal change disease
- HIV renal specific nephropathy is Focal Segmental Glomerulosclerosis
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