Resolution of renal failure after initiation of HAART: three cases and a discussion of the literature, from The AIDS Reader

Jeffrey T. Kirchner, DO

Renal failure is a known complication of HIV infection. The most common form is HIV-associated nephropathy, or HIVAN. It is characterised by high-grade proteinuria with rapid progression to end-stage renal disease.

The kidneys of affected patients appear enlarged on ultrasonography. Histopathologically, there is focal segmental glomerulosclerosis with glomerular collapse. Before the era of HAART, patients with HIVAN had limited survival, although in some cases this was prolonged if dialysis was instituted. Over the past few years, isolated case reports have shown that patients with HIVAN will recover renal function following initiation of HAART. We report three patients believed to have HIVAN who exhibited marked improvement in renal function after treatment with a regimen comprising two nucleoside reverse transcriptase inhibitors and a protease inhibitor.

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