Nephrol Dial Transplant (1993) 8: 11-19
© 1993 European Renal Association-European Dialysis and Transplant Association
research-article
Renal disease associated with HIV infection: a multicentric study of 60 patients from Paris hospitals
1Unité INSERM U28 and Department of Nephrology, Hôpital Broussais Paris, France 2Department of Nephrology, Hôpital Bichat Paris, France 3Department of Nephrology, Hôpital Saint-Louis Paris, France
Correspondence and offprint requests to: Correspondence and offprint requests to: Dominique Nochy MD, Service de Néphrologie, Hopital Broussais, 96 rue Didot, 75014 Paris, France
Sixty HIV-infected patients presenting renal symptoms who underwent percutaneous renal biopsies were analysed. According to the CDC classification, 44 patients were staged in group IV, five in group III, and 11 in group II. Patients were divided in two groups according to their ethnic origin (29 black patients and 31 white patients). Risk factors such as homosexuality, multiple transfusions or intravenous drug abuse (IVDA) were identified in all white patients except two, but in only nine (31%) of the black patients.
Three main patterns of renal disease were observed: focal and segmental glomerulosclerosis (FSGS) was found predominantly in black patients (23 black patients versus 3 Caucasians, P< 0.001) and was associated with the nephrotic syndrome; immune-complex-type glomerulonephritis (ICGN) was frequent in black and white patients (21% and 52% respectively) including four cases of IgA nephritis all seen in white patients; and 10 cases of lupus-like nephritis (4 black and 6 white patients). The frequent hypergammaglobulinaemia in those patients suggests a pathogenic role of polyclonal B cell activation in ICGN. Interstitial nephritis was present in 48 and 52% of the black and white patients respectively and did not seem related to drug toxicity or superimposed infectious disease. In addition to interstitial nephritis, the coexistence of multivisceral lymphocytic infiltration involving accessory salivary glands, liver and/or lung, found in six patients possibly suggests a virus-induced immune disorder.
Keywords: human immunodeficiency virus; renal disease; renal biopsy; Europe experience
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