What is the pathologic classification of HIV-related renal disorders?

Updated: May 09, 2018
  • Author: Moro O Salifu, MD, MPH, FACP; Chief Editor: Vecihi Batuman, MD, FASN  more...
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The spectrum of renal pathology in HIV-positive individuals includes lesions directly related to intrarenal HIV gene expression and lesions related to comorbidities, drug effects, immune dysregulation, and co-infections. [3]   HIV-related kidney diseases fall under four pathologic classifications [4] :

  • Glomerular-dominant nephropathies: HIVAN and immune complex–mediated glomerular diseases 
  • Tubulointerstitial-dominant nephropathies: HIVAN-related tubulointerstitial injury; ART-induced acute tubular injury; drug-induced (other than ART) tubulointerstitial nephritis; direct renal parenchymal infection by viral, bacterial or fungal pathogens
  • Vascular-dominant nephropathies: thrombotic microangiopathy (reported in the early years of the AIDS epidemic, but now rarely reported) and atherosclerosis
  • Other nephropathies in the setting of HIV infection: diabetic nephropathy and age-related nephrosclerosis

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