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Query: UMLS:C0019693 (HIV)
 170,526 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Human immunodeficiency virus-associated nephropathy (HIVAN) is a recognized clinical entity of unknown pathogenesis. A role for viral infection of renal cells in the initiation of this process at present is an intriguing but untested hypothesis. Studies in primate models of acquired immunodeficiency syndrome (AIDS) suggest that injury to the mesangial cell may be central to the sclerosing glomerular lesion characteristic of HIVAN. We therefore tested the infectibility of human mesangial cells (HMC) in vitro by a variety of strains of HIV chosen to include a spectrum of tropisms for different cell types. Productive infection of mesangial cells could not be demonstrated using any of the virus strains. Nonetheless, HIV infection of intrinsic renal cells remains an attractive area of inquiry for understanding the natural history of HIVAN.
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PMID:Human mesangial cells are resistant to productive infection by multiple strains of human immunodeficiency virus types 1 and 2. 173 93

Infection with the human immunodeficiency virus type 1 (HIV-1) can cause a spectrum of renal disease, termed acquired immunodeficiency syndrome (AIDS) nephropathy. The most common clinical manifestations of kidney involvement in HIV-1-infected patients are proteinuria and/or nephrotic syndrome, and the histopathological pattern usually reveals focal segmental glomerulosclerosis. We describe an 8-year-old child with AIDS who presented with recurrent gross hematuria. A kidney biopsy demonstrated IgA nephropathy. This unique case indicates that the range of kidney disease in HIV-infected children may be broader than originally thought, and that these patients warrant a complete evaluation of any renal abnormality.
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PMID:IgA nephropathy in a child with human immunodeficiency virus type 1 infection. 176 86

The nephropathology observed in patients with HIV infection is reviewed. A characteristic, though not specific, nephropathy associated with HIV infection can be encountered in HIV carriers, in patients with AIDS-related complex and in patients with AIDS. HIV-associated nephropathy typically exhibits the features of an aggressive form of focal and segmental glomerulosclerosis. Distinctive pathologic features include: 1) the "collapsing" and predominantly global pattern of glomerulosclerosis; 2) the severity of visceral epithelial cell hypertrophy and droplet formation; 3) the prominent tubular microcysts and cast formation; 4) the focal tubular degenerative features; and 5) the numerous tubuloreticular inclusions.
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PMID:The nephropathology in human immunodeficiency virus (HIV-1) infection. 177 Jul 6

Transgenic mice were produced that bore copies of a defective HIV provirus. The transgenic offspring from three independently derived mouse lines manifested renal disease associated with proteinuria, a high mortality rate, and HIV-specific gene expression in the kidney. An early histopathological lesion in the kidney was focal glomerulosclerosis. Moribund animals had diffuse glomerulosclerosis with prominent microcystic tubular dilatation, tubular epithelial degeneration, and interstitial nephritis. Electron microscopy revealed ultrastructural features consistent with the glomerulosclerosis: effacement of the foot processes of visceral epithelium and an increase in mesangial cell matrix. Transgenic mice variably expressed 6-, 4.3-, and 2-kb HIV-specific RNAs and HIV-related polypeptides in several tissues including kidney. Immunocytostaining revealed the presence of HIV-related protein in the glomeruli of affected animals. Glomerulopathy in these transgenic mice and HIV-associated nephropathy in man have similar features.
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PMID:HIV-associated nephropathy in transgenic mice expressing HIV-1 genes. 192 69

A 37-year-old Caucasian male homosexual presented with hematuria and rapidly progressive acute renal failure. He was found to have proteinuria and microscopic hematuria as well as RBC casts. Investigations revealed polyclonal gammopathy with five times normal serum IgA levels as well as elevated serum IgG. Renal biopsy showed evidence of crescentic IgA nephropathy with ultrastructural changes of tubuloreticular inclusions described in HIV nephropathy. He was found to be positive for human immunodeficiency viral antibodies. Renal function improved during follow-up after two doses of 1 g each of methylprednisone. In our opinion, this is the first case of HIV-related crescentic IgA nephropathy. HIV testing should be performed more frequently in patients presenting with acute glomerular diseases.
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PMID:Crescentic IgA nephropathy as a manifestation of human immune deficiency virus infection. 180 45

Pathologic lesions in children with acquired immunodeficiency syndrome (AIDS) can be classified into three broad categories: (1) primary lesions related directly to infection by human immunodeficiency virus (HIV) (e.g., in the lymphoreticular system and brain); (2) associated lesions related to direct or indirect sequelae of HIV infection (e.g., opportunistic infections, lymphoid interstitial pneumonitis, and so forth); and (3) lesions of undetermined pathogenesis (e.g., cardiomyopathy, nephropathy, and so forth). The pathologic features of the various lesions in these three categories are described. Clinical relevance of the pathologic study of AIDS is discussed. Data on perinatal pathology of AIDS is reviewed.
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PMID:Pathology of childhood AIDS. 198 21

Clinical and nephropathologic findings in autopsy material from 7 children with acquired immune deficiency syndrome (AIDS), 13 with severe combined immune deficiency (SCID), and 6 with a variety of other congenital immune deficiencies were reviewed in an effort to understand better the pathophysiology of the AIDS-related nephropathy. Non-HIV viral infection seemed to be associated with the development of the pathologic changes considered to be components of the AIDS-related nephropathy, and these changes, including focal segmental glomerulosclerosis (FSGS) and tubular epithelial cell injury and ectasia, were not limited to the kidneys of children with AIDS but were present in many of the congenital immune deficiencies. Of the 5 children with congenital AIDS, only the 3 who survived longer than a year developed AIDS-related nephropathy, whereas the two children with transfusion-acquired AIDS did not develop renal disease despite surviving for several years after initial infection.
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PMID:Pathology of the kidney in childhood immunodeficiency: AIDS-related nephropathy is not unique. 201 93

Patients with HIV infection can manifest a spectrum of potentially reversible forms of acute renal failure and a unique form of nephropathy clinically characterized by nephrotic syndrome, a rapid progression to irreversible uremia in weeks, and a poor prognosis despite maintenance dialysis therapy. Typical histologic features consist of focal and segmental glomerulosclerosis, with some distinct and unusual electron microscopic features in the kidney. HIV-associated nephropathy (HIVAN) is predominantly a disease of young black men; about half are intravenous drug addicts and the remaining half belong to various groups at risk for HIV infection. Evidence points to a viral etiology in the pathogenesis of HIVAN. Currently, no effective forms of therapy are available for HIV-associated nephropathy. It is hoped that the newer antiviral agents given early and for prolonged periods may change the natural history of HIVAN, which at present is a fulminant form of irreversible renal syndrome.
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PMID:Human immunodeficiency virus (HIV) associated nephropathy. 203 84

We investigated the presence of HIV antigen in dialysis fluid of patients with end-stage renal disease (ESRD) undergoing continuous ambulatory peritoneal dialysis (CAPD), previously known to be infected with this virus. Sixteen adult patients and 6 adult volunteers were included in the study in 4 groups as follows: Group A: 3 patients on CAPD, previously known to be positive for serum HIV antibodies; Group B: 7 patients on CAPD, serum HIV negative; Group C: 6 AIDS patients without renal disease; and Group D: 6 healthy volunteers. Of the 3 patients of Group A, the HIV-1 Ag was positive in dialysis fluid in only 2. In 1, serum Ab and Ag were present, while in the others only serum Ab was detected. The samples from Group B were all negative for the viral antigen in dialysis fluid. We conclude that dialysis fluid of HIV-infected patients may contain the Ag and is therefore potentially infective. The presence of the HIV antigen was not constant, and was not related to antigenemia. It is possible that the presence of the Ag depends on local factors that influence viral replication or to alterations in the permeability of the peritoneal membrane. We discuss other possible factors that could influence the presence of viral Ag in peritoneal dialysis fluid.
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PMID:Recovery of HIV antigen in peritoneal dialysis fluid. 208 86

The existence of an HIV-related nephropathy as a distinct disease entity is controversial. Twelve patients affected by HIV infection (eight drug-abusers, three homosexuals and one black heterosexual) who showed nephrotic syndrome (five patients) or urinary abnormalities (seven patients), four with renal insufficiency, were submitted to renal biopsy. Six patients were in pre-AIDS, six had AIDS. Light microscopy, performed in all cases, showed focal segmental glomerular sclerosis in nine patients, a moderate hypercellularity in six, vacuolisation of visceral epithelium in ten, focal collapsed tuft in seven, and tubular microcystic dilatation with large dense protein casts in lumina in seven. Immunofluorescence, available in 11 patients, showed small deposits in mesangium or mesangial and subendothelial spaces. IgG, IgM, and C3 were more frequently found, while three cases were negative. Electron-microscopy (five patients), besides confirming light-microscopy changes, showed several tubuloreticular inclusions (four patients), nuclear bodies (mainly complex) in nuclei of tubular cells (three patients), and nuclear granulofibrillary transformation of tubular cells. Various histological aspects and clinical data confirm the hypothesis that HIV nephropathy can be considered as a separate entity, different from heroin nephropathy and idiopathic focal glomerulosclerosis.
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PMID:HIV-associated nephropathy: a new entity. A study of 12 cases. 212 70


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