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Differentiating HIV-associated Nephropathy from Antiretroviral Drug-Induced Nephropathy: A Clinical Challenge

  • Complications of Antiretroviral Therapy (JM Kilby, Section Editor)
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Abstract

With the introduction of potent combination antiretroviral therapy (cART) into clinical practice, HIV-infected patients have garnered much benefit. However, kidney disease continues to be a potential complication in this group. Whereas HIV-associated nephropathy (HIVAN) was the major renal complication prior to cART, co-morbid diseases and adverse renal effects of various drugs, in particular cART, now complicate the landscape. Clinicians now must differentiate HIVAN from cART nephrotoxicity. While sometimes this is easy and relatively straightforward, often the clinician faces a difficult challenge distinguishing these two etiologies of kidney disease. This review will discuss HIVAN and cART-related kidney disease and review the clinical and laboratory data that may be useful in differentiating these processes. Often, however, kidney biopsy may be required to differentiate HIVAN from cART nephrotoxicity as well as other kidney lesions associated with concurrent co-morbidities, both infectious and non-infectious.

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Neelja Kumar and Mark A. Perazella declare that they have no conflict of interest

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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  1. Section of Nephrology, Department of Medicine, Yale University School of Medicine, BB 114, 330 Cedar Street, New Haven, CT, 06520-8029, USA

    Neelja Kumar & Mark A. Perazella

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  1. Neelja Kumar
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  2. Mark A. Perazella
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Correspondence to Mark A. Perazella.

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Kumar, N., Perazella, M.A. Differentiating HIV-associated Nephropathy from Antiretroviral Drug-Induced Nephropathy: A Clinical Challenge. Curr HIV/AIDS Rep 11, 202–211 (2014). https://doi.org/10.1007/s11904-014-0209-9

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  • DOI: https://doi.org/10.1007/s11904-014-0209-9

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