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Acute interstitial nephritis of HIV-positive patients under atazanavir and tenofovir therapy in a retrospective analysis of kidney biopsies

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Abstract

We performed a retrospective analysis on kidney biopsies of 30 human immunodeficiency virus (HIV)-positive patients. Twenty-two of them received highly active antiretroviral therapy (HAART). Tenofovir containing HAART together with atazanavir, a new protease inhibitor, was administered to three patients. All of them developed acute renal failure. The kidney biopsies of these patients showed an acute interstitial nephritis or a chronic interstitial nephritis with an acute component. Withdrawal of atazanavir and tenofovir resulted in recovery of renal function in all three patients. Acute interstitial nephritis was observed only in 1 of 19 patients without atazanavir or tenofovir treatment. We conclude that acute interstitial nephritis and consecutive acute renal failure is a relevant side effect of atazanavir and tenofovir therapy in HIV-positive patients.

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Acknowledgments

The technical assistance of Mrs. Juliane Bigott and Mrs. Doris Guntersweiler is highly appreciated. Mr. N. Wey helped in the illustration. The study complies with the current ethical laws of the involved institutions.

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Authors and Affiliations

  1. Department of Pathology, Institute of Surgical Pathology, University Hospital Zurich, Schmelzbergstrasse 12, CH-8091, Zurich, Switzerland

    Simone Schmid, Holger Moch & Zsuzsanna Varga

  2. Department of Internal Medicine, Division of Infectious Diseases, University Hospital Zurich, Zurich, Switzerland

    Milos Opravil & Milo Huber

  3. Department of Nephrology, City Hospital Waid, Zurich, Switzerland

    Michael Moddel, Rahel Pfammatter & Gerald Keusch

  4. Clinic of Nephrology, University Hospital Zurich, Zurich, Switzerland

    Patrice Ambuhl & Rudolf P. Wuthrich

Authors
  1. Simone Schmid
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  2. Milos Opravil
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  3. Michael Moddel
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  4. Milo Huber
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  5. Rahel Pfammatter
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  6. Gerald Keusch
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  7. Patrice Ambuhl
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  8. Rudolf P. Wuthrich
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  9. Holger Moch
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  10. Zsuzsanna Varga
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Correspondence to Simone Schmid.

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Schmid, S., Opravil, M., Moddel, M. et al. Acute interstitial nephritis of HIV-positive patients under atazanavir and tenofovir therapy in a retrospective analysis of kidney biopsies. Virchows Arch 450, 665–670 (2007). https://doi.org/10.1007/s00428-007-0418-3

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  • DOI: https://doi.org/10.1007/s00428-007-0418-3

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