HIV associated nephropathy risk factors: Difference between revisions
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== Overview == | == Overview == | ||
The risk factors that attribute to HIV-associated nephropathy are similar to those seen with HIV. | The risk factors that attribute to HIV-associated nephropathy are similar to those seen with HIV. Positive predicators for HIV-associated nephropathy include: Apolipoproetin-1 (APOL1) gene, low CD-4 count, high viral load, low CD-4 count, proteinuria (nephrotic range), and higher level of renal echogenicity on ultrasound. | ||
== Risk Factors == | == 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.<ref name="pmid11389504">{{cite journal| author=Szczech LA| title=Renal diseases associated with human immunodeficiency virus infection: epidemiology, clinical course, and management. | journal=Clin Infect Dis | year= 2001 | volume= 33 | issue= 1 | pages= 115-9 | pmid=11389504 | doi=10.1086/320893 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11389504 }}</ref><ref name="pmid209799642">{{cite journal| author=Naicker S, Fabian J| title=Risk factors for the development of chronic kidney disease with HIV/AIDS. | journal=Clin Nephrol | year= 2010 | volume= 74 Suppl 1 | issue= | pages= S51-6 | pmid=20979964 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20979964 }}</ref><ref name="pmid23685946">{{cite journal| author=Foy MC, Estrella MM, Lucas GM, Tahir F, Fine DM, Moore RD et al.| title=Comparison of risk factors and outcomes in HIV immune complex kidney disease and HIV-associated nephropathy. | journal=Clin J Am Soc Nephrol | year= 2013 | volume= 8 | issue= 9 | pages= 1524-32 | pmid=23685946 | doi=10.2215/CJN.10991012 | pmc=3805081 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23685946 }}</ref> | 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.<ref name="pmid11389504">{{cite journal| author=Szczech LA| title=Renal diseases associated with human immunodeficiency virus infection: epidemiology, clinical course, and management. | journal=Clin Infect Dis | year= 2001 | volume= 33 | issue= 1 | pages= 115-9 | pmid=11389504 | doi=10.1086/320893 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11389504 }}</ref><ref name="pmid209799642">{{cite journal| author=Naicker S, Fabian J| title=Risk factors for the development of chronic kidney disease with HIV/AIDS. | journal=Clin Nephrol | year= 2010 | volume= 74 Suppl 1 | issue= | pages= S51-6 | pmid=20979964 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20979964 }}</ref><ref name="pmid23685946">{{cite journal| author=Foy MC, Estrella MM, Lucas GM, Tahir F, Fine DM, Moore RD et al.| title=Comparison of risk factors and outcomes in HIV immune complex kidney disease and HIV-associated nephropathy. | journal=Clin J Am Soc Nephrol | year= 2013 | volume= 8 | issue= 9 | pages= 1524-32 | pmid=23685946 | doi=10.2215/CJN.10991012 | pmc=3805081 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23685946 }}</ref> | ||
The predictors for the development of HIV-associated nephropathy include: | |||
=== Positive predictors for the development of HIV-associated nephropathy === | |||
* Black race [56] | |||
* High-risk alleles (G1/G2) for Apolipoprotein 1 (APOL1) [57] | |||
* CD4-positive T cell count < 200/ml [40] | |||
* Proteinuria > 3 g/24 h [65] | |||
* GFR between 0 and 14 ml/min [42] | |||
* Increased renal echogenicity on ultrasound [67] | |||
=== Negative predictors for the development of HIV-associated nephropathy === | |||
* Caucasian race | |||
* No high-risk alleles (G1/G2) for Apolipoprotein 1 (APOL1) [61] | |||
* GFR >90 ml/min [42] | |||
* Normal level of renal echogenicity on ultrasound [67] | |||
* Viral load (HIV-1 RNA) <400 copies/ml [64] | |||
* HIV-1 proviral DNA level of <10 copies/<math>10^5</math>peripheral blood mononuclear cells [45] | |||
==References== | ==References== | ||
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Overview
The risk factors that attribute to HIV-associated nephropathy are similar to those seen with HIV. Positive predicators for HIV-associated nephropathy include: Apolipoproetin-1 (APOL1) gene, low CD-4 count, high viral load, low CD-4 count, proteinuria (nephrotic range), and higher level of renal echogenicity on ultrasound.
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.[1][2][3]
The predictors for the development of HIV-associated nephropathy include:
Positive predictors for the development of HIV-associated nephropathy
- Black race [56]
- High-risk alleles (G1/G2) for Apolipoprotein 1 (APOL1) [57]
- CD4-positive T cell count < 200/ml [40]
- Proteinuria > 3 g/24 h [65]
- GFR between 0 and 14 ml/min [42]
- Increased renal echogenicity on ultrasound [67]
Negative predictors for the development of HIV-associated nephropathy
- Caucasian race
- No high-risk alleles (G1/G2) for Apolipoprotein 1 (APOL1) [61]
- GFR >90 ml/min [42]
- Normal level of renal echogenicity on ultrasound [67]
- Viral load (HIV-1 RNA) <400 copies/ml [64]
- HIV-1 proviral DNA level of <10 copies/<math>10^5</math>peripheral blood mononuclear cells [45]
References
- ↑ 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.