Figure 722

Nephropathies associated with HIV. The literature refers to the glomerulosclerosis associated with human immunodeficiency virus (HIV) as HIV-associated nephropathy. However, HIV-associated nephropathies may include a spectrum of renal diseases, including HIV-associated glomerulosclerosis, HIV-associated immune-complex glomerulonephritis (focal or diffuse proliferative glomerulonephritis, immunoglobulin A nephropathy) and HIV-associated hemolytic uremic syndrome/thrombotic thrombocytopenic purpura (HUS/TTP). Diffuse mesangial hyperplasia and minimal change disease also may be associated with HIV, particularly in children. Therefore, the nomenclature of HIV-associated nephropathies should be amended to list the associated qualifying histologic feature [156]. All types of glomeru-lopathies have been observed in patients with HIV-infection. Their prevalence and severity vary with the population studied. Focal segmental or global glomerulosclerosis is most prevalent in black adults. In whites, proliferative and other types of glomerulonephritis predominate. In children with perinatal acquired immunodeficiency syndrome, glomerulosclerosis, diffuse mesangial hyperplasia, and proliferative glomerulonephritis are equally prevalent.

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