What is the role of renal biopsy in the diagnosis of HIV-associated nephropathy (HIVAN)?

Updated: May 09, 2018
  • Author: Moro O Salifu, MD, MPH, FACP; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

Answer

The decision to obtain a biopsy sample is somewhat controversial in the general medical community. Even if a patient presents with the classic clinical features of HIV-associated neuropathy (HIVAN), clinical consideration is predictive of the biopsy diagnosis in only 55-60% of patients.

Therefore, to distinguish HIVAN from other forms of renal disease (eg, immune complex glomerulonephritis, immunoglobulin-A nephropathy), patients who are seropositive for HIV require a renal biopsy. The typical practice is to obtain a renal biopsy specimen if the patient's daily protein excretion is greater than 1 g.


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