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{{AIDS}}
__NOTOC__
{{CMG}}
'''For patient information, click [[AIDS (patient information)|here]]'''
==Overview==
{{HIV associated nephropathy}}
'''HIV-Associated Nephropathy''' (HIVAN) is a type of collapsing [[FSGS]].  Serious renal complication of advanced [[HIV]] infection and [[AIDS]] leading to chronic and eventually [[end stage renal failure]](ESRF).  HIVAN is caused by direct infection of the renal cells with the HIV-1 virus and leads to renal damage through the viral gene products.  It could also be caused by changes in the release of [[cytokines]] during HIV infection.
{{CMG}}{{APM}};{{AE}}{{SHA}}{{KW}}
==[[HIV associated nephropathy overview|Overview]]==


Usually occurs only in advanced disease and approximately 80%
==[[HIV associated nephropathy historical perspective|Historical Perspective]]==
of patients with HIVAN have a [[CD4]] count of less than 200.  HIVAN presents with [[nephrotic syndrome]] and progressive [[renal failure]].  Despite being a cause of chronic renal failure kidney sizes are usually normal or large.


===Pathophysiology
==[[HIV associated nephropathy pathophysiology|Pathophysiology]]==
===Pathology===
Involves all components of the [[nephron]].  Typical findings are that of collapsing [[FSGS]] (Focal segmental glomerulosclerosis)and mycrocystic tubular dilatation.


==Incidence==
==[[HIV associated nephropathy causes|Causes]]==
Much more common in Black and African American patients with [[HIV]].  In the USA 12% of patients dying with [[AIDS]] have histologically proven HIVAN, the worldwide incidence amongst [[AIDS]] patients appears to be similar.  A South African study at [[Tygerberg Hospital]], [[Stellenbosch University]], has shown HIVAN histology in 33/61(54%) [[biopsies]] performed in HIV positive patients. 


Among black adults in the USA it is the third most common cause of ESRF.
==[[HIV associated nephropathy differential diagnosis|Differentiating HIV associated nephropathy from other Diseases]]==
 
==[[HIV associated nephropathy epidemiology and demographics|Epidemiology and Demographics]]==
 
==[[HIV associated nephropathy risk factors|Risk Factors]]==
 
==[[HIV associated nephropathy screening|Screening]]==
 
==[[HIV associated nephropathy natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
 
==Diagnosis==
[[HIV associated nephropathy history and symptoms|History and Symptoms]] | [[HIV associated nephropathy physical examination|Physical Examination]] |[[HIV associated nephropathy  diagnostic study of choice|Diagnostic Study of Choice]] | [[HIV associated nephropathy laboratory findings|Laboratory Findings]] | [[HIV associated nephropathy KUB x ray|KUB X Ray]] | [[HIV associated nephropathy CT|CT]] | [[HIV associated nephropathy MRI|MRI]] | [[HIV associated nephropathy ultrasound|Ultrasound]] | [[HIV associated nephropathy other imaging findings|Other Imaging Findings]] | [[HIV associated nephropathy other diagnostic studies|Other Diagnostic Studies]]


==Treatment==
==Treatment==
There is as yet inadeqaute data from randomised controlled trials.
[[HIV associated nephropathy medical therapy|Medical Therapy]] | [[HIV associated nephropathy surgery|Surgery]] | [[HIV associated nephropathy prevention|Prevention]] | [[HIV associated nephropathy cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] |  [[HIV associated nephropathy future or investigational therapies|Future or Investigational Therapies]]


Treatment with [[HAART]] and [[ACE inhibitors]]/[[Angiotensin receptor blockers]] has been shown to be beneficial and should be given to all patients unless otherwise contra-indicated.  General renoprotective measures and the treatment of the complications of nephrotic syndrome and renal failure are adjunctive. 
==Case Studies==
 
[[Corticosteroid]] treatment can be useful in patients who do not respond to the above treatment.  There is some evidence that [[cyclophosphamide]] might be helpful in selective cases, however further trials are required on both steroids and [[cyclophosphamide]] before these drugs can become standardised treatmen if at all.


[[HIV associated nephropathy case study one|Case #1]]




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[[Category:HIV/AIDS]]
[[Category:HIV/AIDS]]
[[Category:Immune system disorders]]
[[Category:Immune system disorders]]
[[Category:Infectious disease]]
 
[[category:viral diseases]]
[[category:viral diseases]]


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{{WH}}
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{{WikiDoc Sources}}

Latest revision as of 11:34, 30 June 2020

For patient information, click here

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Overview

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Ali Poyan Mehr, M.D. [2];Associate Editor(s)-in-Chief: Shakiba Hassanzadeh, MD[3]Krzysztof Wierzbicki M.D. [4]

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating HIV associated nephropathy from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination |Diagnostic Study of Choice | Laboratory Findings | KUB X Ray | CT | MRI | Ultrasound | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

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