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Glomerulonephritis pp 509–521Cite as

HIVAN, Adult

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Abstract

HIV infection is associated with an increased incidence of acute and chronic kidney disease. HIV-positive individuals are at risk for HIV-associated glomerular diseases, including HIV-associated nephropathy (HIVAN) and HIV immune complex kidney disease, but are also susceptible to antiretroviral nephrotoxicity and comorbid kidney disease. Kidney biopsy is required for definitive diagnosis in the majority of cases. HIVAN is a collapsing form of focal segmental glomerulosclerosis with associated tubulointerstitial lesions, occurring primarily in individuals of African descent who have advanced HIV disease. The first-line treatment of HIVAN is antiretroviral therapy, with the addition of ACE inhibitors or angiotensin receptor blockers as adjunctive therapy. The role of antiretroviral therapy is less clear in HIV immune complex kidney disease and comorbid kidney disease. Even with effective therapy, HIV-positive individuals are at increased risk of progression to end-stage renal disease. The management of end-stage renal disease is largely based on guidelines developed for the general population, with special consideration of drug–drug interactions in patients with well-controlled HIV infection who may be candidates for kidney transplantation.

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Authors and Affiliations

  1. Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Mukta Baweja, Yotam Arens & Christina Wyatt

  2. Department of Anatomic Pathology, Cleveland Clinic, Cleveland, OH, USA

    Leal C. Herlitz

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  1. Mukta Baweja
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  2. Yotam Arens
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  3. Leal C. Herlitz
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  4. Christina Wyatt
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Correspondence to Christina Wyatt .

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Editors and Affiliations

  1. Department of Pediatrics, NYU Langone Medical Center, New York, NY, USA

    Howard Trachtman

  2. Department of Anatomic Pathology, Cleveland Clinic, Cleveland, OH, USA

    Leal C. Herlitz

  3. Nephrology, University of Illinois at Chicago College of Medicine, Chicago, IL, USA

    Edgar V. Lerma

  4. Renal, Electrolyte and Hypertension Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Jonathan J. Hogan

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Baweja, M., Arens, Y., Herlitz, L.C., Wyatt, C. (2019). HIVAN, Adult. In: Trachtman, H., Herlitz, L., Lerma, E., Hogan, J. (eds) Glomerulonephritis. Springer, Cham. https://doi.org/10.1007/978-3-319-49379-4_31

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