Open AccessHIV-Associated Nephropathy in 2022
Author(s) -
Rivera Frederick Berro,
Ansay Marie Francesca Mapua,
Golbin Jem Marie,
Alfonso Pia Gabrielle I.,
Mangubat Gerard Francis E.,
Menghrajani Rajiv Hans Solita,
Placino Siena,
Taliño Marianne Katharina Vicera,
De Luna Deogracias Villa,
Cabrera Nicolo,
Trinidad Carlo Nemesio,
Kazory Amir
Publication year - 2022
Publication title -
glomerular diseases
Language(s) - Uncategorized
Resource type - Journals
eISSN - 2673-3633
pISSN - 2673-3625
DOI - 10.1159/000526868
Subject(s) - review article
Background: HIV-associated nephropathy (HIVAN) is a renal parenchymal disease that occurs exclusively in people living with HIV. It is a serious kidney condition that may possibly lead to end-stage kidney disease, particularly in the HIV-1 seropositive patients. Summary: The African-American population has increased susceptibility to this comorbidity due to a strong association found in the APOL1 gene, specifically two missense mutations in the G1 allele and a frameshift deletion in the G2 allele, although a “second-hit” event is postulated to have a role in the development of HIVAN. HIVAN presents with proteinuria, particularly in the nephrotic range, as with other kidney diseases. The diagnosis requires biopsy and typically presents with collapsing subtype focal segmental glomerulosclerosis and microcyst formation in the tubulointerstitial region. Gaps still exist in the definitive treatment of HIVAN – concurrent use of antiretroviral therapy and adjunctive management with like renal-angiotensin-aldosterone system inhibitors, steroids, or renal replacement therapy showed benefits. Key Message: This study reviews the current understanding of HIVAN including its epidemiology, mechanism of disease, related genetic factors, clinical profile, and pathophysiologic effects of management options for patients.