HIV associated nephropathy risk factors
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Shakiba Hassanzadeh, MD[2]
Overview
The risk factors that attribute to HIV-associated nephropathy are similar to those seen with HIV. Positive predicators for HIV-associated nephropathy include: polymorphysim of Apolipoproetin-1 (APOL1) gene, high viral load, low CD-4 count, proteinuria (nephrotic range), and higher level of renal echogenicity on ultrasound.[1]
Risk Factors
The majority of patients developing HIV-associated nephropathy, is through the acquisition of HIV-1. The acquisition of the disease can be attributed to unprotected sexual relations between partners (one partner having HIV), sharing of needles, and or contaminated blood transfusions. However, the greatest risk factor attributed to development of HIV-associated nephropathy is the black race.[2][3][4]
The predictors for the development of HIV-associated nephropathy include:[1]
Positive predictors for the development of HIV-associated nephropathy
- Black race[5]
- High-risk alleles (G1/G2) for Apolipoproetin-1 (APOL1)[6]
- CD4-positive T cell count < 200/ml[7]
- Proteinuria > 3 g/24 h[8]
- GFR between 0 and 14 ml/min[9]
- Increased renal echogenicity on ultrasound[10]
Negative predictors for the development of HIV-associated nephropathy
- Caucasian race
- No high-risk alleles (G1/G2) for Apolipoproetin-1 (APOL1)[11]
- GFR >90 ml/min[9]
- Normal level of renal echogenicity on ultrasound[10]
- Viral load (HIV-1 RNA) <400 copies/ml[12]
- HIV-1 proviral DNA level of <10 copies/<math>10^5</math>peripheral blood mononuclear cells[13]
References
- ↑ 1.0 1.1 Waheed S, Atta MG (2014). "Predictors of HIV-associated nephropathy". Expert Rev Anti Infect Ther. 12 (5): 555–63. doi:10.1586/14787210.2014.901170. PMID 24655211.
- ↑ Szczech LA (2001). "Renal diseases associated with human immunodeficiency virus infection: epidemiology, clinical course, and management". Clin Infect Dis. 33 (1): 115–9. doi:10.1086/320893. PMID 11389504.
- ↑ Naicker S, Fabian J (2010). "Risk factors for the development of chronic kidney disease with HIV/AIDS". Clin Nephrol. 74 Suppl 1 ( ): S51–6. PMID 20979964.
- ↑ Foy MC, Estrella MM, Lucas GM, Tahir F, Fine DM, Moore RD; et al. (2013). "Comparison of risk factors and outcomes in HIV immune complex kidney disease and HIV-associated nephropathy". Clin J Am Soc Nephrol. 8 (9): 1524–32. doi:10.2215/CJN.10991012. PMC 3805081. PMID 23685946.
- ↑ Bigé N, Lanternier F, Viard JP, Kamgang P, Daugas E, Elie C; et al. (2012). "Presentation of HIV-associated nephropathy and outcome in HAART-treated patients". Nephrol Dial Transplant. 27 (3): 1114–21. doi:10.1093/ndt/gfr376. PMID 21745806.
- ↑ Genovese G, Friedman DJ, Ross MD, Lecordier L, Uzureau P, Freedman BI; et al. (2010). "Association of trypanolytic ApoL1 variants with kidney disease in African Americans". Science. 329 (5993): 841–5. doi:10.1126/science.1193032. PMC 2980843. PMID 20647424.
- ↑ Lescure FX, Flateau C, Pacanowski J, Brocheriou I, Rondeau E, Girard PM; et al. (2012). "HIV-associated kidney glomerular diseases: changes with time and HAART". Nephrol Dial Transplant. 27 (6): 2349–55. doi:10.1093/ndt/gfr676. PMID 22248510.
- ↑ Atta MG, Choi MJ, Longenecker JC, Haymart M, Wu J, Nagajothi N; et al. (2005). "Nephrotic range proteinuria and CD4 count as noninvasive indicators of HIV-associated nephropathy". Am J Med. 118 (11): 1288. doi:10.1016/j.amjmed.2005.05.027. PMID 16271919.
- ↑ 9.0 9.1 Berliner AR, Fine DM, Lucas GM, Rahman MH, Racusen LC, Scheel PJ; et al. (2008). "Observations on a cohort of HIV-infected patients undergoing native renal biopsy". Am J Nephrol. 28 (3): 478–86. doi:10.1159/000112851. PMID 18176076.
- ↑ 10.0 10.1 Atta MG, Longenecker JC, Fine DM, Nagajothi N, Grover DS, Wu J; et al. (2004). "Sonography as a predictor of human immunodeficiency virus-associated nephropathy". J Ultrasound Med. 23 (5): 603–10, quiz 612-3. doi:10.7863/jum.2004.23.5.603. PMID 15154526.
- ↑ Atta MG, Estrella MM, Kuperman M, Foy MC, Fine DM, Racusen LC; et al. (2012). "HIV-associated nephropathy patients with and without apolipoprotein L1 gene variants have similar clinical and pathological characteristics". Kidney Int. 82 (3): 338–43. doi:10.1038/ki.2012.111. PMC 3463138. PMID 22495294.
- ↑ Estrella M, Fine DM, Gallant JE, Rahman MH, Nagajothi N, Racusen LC; et al. (2006). "HIV type 1 RNA level as a clinical indicator of renal pathology in HIV-infected patients". Clin Infect Dis. 43 (3): 377–80. doi:10.1086/505497. PMID 16804855.
- ↑ Izzedine H, Acharya V, Wirden M, Cluzel P, Sene D, Lucas GM; et al. (2011). "Role of HIV-1 DNA levels as clinical marker of HIV-1-associated nephropathies". Nephrol Dial Transplant. 26 (2): 580–3. doi:10.1093/ndt/gfq414. PMID 20624771.