BACKGROUND: The pathogenesis and natural history of HIV-associated immune complex kidney disease (HIVICK) is not well understood. Key questions remain unanswered, including the role of HIV infection and replication in disease development and the efficacy of antiretroviral therapy (ART) in the prevention and treatment of disease. METHODS: In this multicentre study, we describe the renal pathology of HIVICK and compare the clinical characteristics of patients with HIVICK with those with IgA nephropathy and HIV-associated nephropathy (HIVAN). Poisson regression models were used to identify risk factors for each of these pathologies. RESULTS: Between 1998 and 2012, 65 patients were diagnosed with HIVICK, 27 with IgA nephropathy and 70 with HIVAN. Black ethnicity and HIV RNA were associated with HIVICK, receipt of ART with IgA nephropathy and black ethnicity and CD4 cell count with HIVAN. HIVICK was associated with lower rates of progression to end-stage kidney disease compared with HIVAN and IgA nephropathy (P < 0.0001). Patients with HIVICK who initiated ART and achieved suppression of HIV RNA experienced improvements in estimated glomerular filtration rate and proteinuria. CONCLUSIONS: These findings suggest a pathogenic role for HIV replication in the development of HIVICK and that ART may improve kidney function in patients who have detectable HIV RNA at the time of HIVICK diagnosis. Our data also suggest that IgA nephropathy should be viewed as a separate entity and not included in the HIVICK spectrum.
BACKGROUND: The pathogenesis and natural history of HIV-associated immune complex kidney disease (HIVICK) is not well understood. Key questions remain unanswered, including the role of HIV infection and replication in disease development and the efficacy of antiretroviral therapy (ART) in the prevention and treatment of disease. METHODS: In this multicentre study, we describe the renal pathology of HIVICK and compare the clinical characteristics of patients with HIVICK with those with IgA nephropathy and HIV-associated nephropathy (HIVAN). Poisson regression models were used to identify risk factors for each of these pathologies. RESULTS: Between 1998 and 2012, 65 patients were diagnosed with HIVICK, 27 with IgA nephropathy and 70 with HIVAN. Black ethnicity and HIV RNA were associated with HIVICK, receipt of ART with IgA nephropathy and black ethnicity and CD4 cell count with HIVAN. HIVICK was associated with lower rates of progression to end-stage kidney disease compared with HIVAN and IgA nephropathy (P < 0.0001). Patients with HIVICK who initiated ART and achieved suppression of HIV RNA experienced improvements in estimated glomerular filtration rate and proteinuria. CONCLUSIONS: These findings suggest a pathogenic role for HIV replication in the development of HIVICK and that ART may improve kidney function in patients who have detectable HIV RNA at the time of HIVICK diagnosis. Our data also suggest that IgA nephropathy should be viewed as a separate entity and not included in the HIVICK spectrum.
Authors: Anthony N Muiru; Erin Madden; Ani Chilingirian; Anna D Rubinsky; Rebecca Scherzer; Richard Moore; Celia P Corona Villalobos; Jose Manuel Monroy Trujillo; Chirag R Parikh; Chi-Yuan Hsu; Michael G Shlipak; Michelle M Estrella Journal: HIV Med Date: 2021-12-12 Impact factor: 3.094
Authors: Charles R Swanepoel; Mohamed G Atta; Vivette D D'Agati; Michelle M Estrella; Agnes B Fogo; Saraladevi Naicker; Frank A Post; Nicola Wearne; Cheryl A Winkler; Michael Cheung; David C Wheeler; Wolfgang C Winkelmayer; Christina M Wyatt Journal: Kidney Int Date: 2018-02-03 Impact factor: 10.612
Authors: Nazik Elmalaika Husain; Mohamed H Ahmed; Ahmed O Almobarak; Sufian K Noor; Wadie M Elmadhoun; Heitham Awadalla; Clare L Woodward; Dushyant Mital Journal: J Clin Med Res Date: 2017-12-01
Authors: Rachel K Y Hung; Beatriz Santana-Suarez; Elizabeth Binns-Roemer; Lucy Campbell; Kate Bramham; Lisa Hamzah; Julie Fox; James E Burns; Amanda Clarke; Rachel Vincent; Rachael Jones; David A Price; Denis Onyango; Mark Harber; Rachel Hilton; John W Booth; Caroline A Sabin; Cheryl A Winkler; Frank A Post Journal: EClinicalMedicine Date: 2021-07-08
Authors: Nicholas Meyer; Wendy Cooper; Paul Kirwan; Roger Garsia; Scott Dunkley; David M Gracey Journal: BMC Nephrol Date: 2021-07-22 Impact factor: 2.388