Kidney disease in HIV: Moving beyond HIV-associated nephropathy

Vasantha Jotwani, Mohamed Atta, Michelle M. Estrella

Research output: Contribution to journalReview article

Abstract

In developed countries, remarkable advances in antiretroviral therapy have transformed HIV infection into a chronic condition. As a result, HIV-associated nephropathy, the classic HIV-driven kidney lesion among individuals of African descent, has largely disappeared in these regions.However,HIV-positive blacks continue to have much higher rates of ESRD than HIV-positive whites, which could be attributed to the APOL1 renal risk variants. Additionally, HIV-positive individuals face adverse consequences beyond HIV itself, including traditional risk factors for CKD and nephrotoxic effects of antiretroviral therapy. Concerns for nephrotoxicity also extend to HIV-negative individuals using tenofovir disoproxil fumarate-based pre-exposure prophylaxis for the prevention of HIV infection. Therefore, CKD remains an important comorbid condition in the HIV-positive population and an emerging concern among HIV-negative persons receiving pre-exposure prophylaxis. With the improved longevity of HIV-positive individuals, a kidney transplant has become a viable option for many who have progressed to ESRD. Herein, we review the growing knowledge regarding the APOL1 renal risk variants in the context of HIV infection, antiretroviral therapy-related nephrotoxicity, and developments in kidney transplantation among HIV-positive individuals.

Original languageEnglish (US)
Pages (from-to)3142-3154
Number of pages13
JournalJournal of the American Society of Nephrology
Volume28
Issue number11
DOIs
StatePublished - Nov 1 2017

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AIDS-Associated Nephropathy
Kidney Diseases
HIV
HIV Infections
Kidney
Tenofovir
Chronic Kidney Failure
Developed Countries
Kidney Transplantation
Therapeutics

ASJC Scopus subject areas

  • Nephrology

Cite this

Kidney disease in HIV : Moving beyond HIV-associated nephropathy. / Jotwani, Vasantha; Atta, Mohamed; Estrella, Michelle M.

In: Journal of the American Society of Nephrology, Vol. 28, No. 11, 01.11.2017, p. 3142-3154.

Research output: Contribution to journalReview article

Jotwani, Vasantha ; Atta, Mohamed ; Estrella, Michelle M. / Kidney disease in HIV : Moving beyond HIV-associated nephropathy. In: Journal of the American Society of Nephrology. 2017 ; Vol. 28, No. 11. pp. 3142-3154.
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