HIV-focal segmental glomerulosclerosis or HIV-associated nephropathy in a Greek patient
Journal Title: Αρχεία Ελληνικής Ιατρικής - Year 2004, Vol 21, Issue 6
Abstract
HIV-associated nephropathy (HIVAN) is the most common renal disease in HIV-infected patients. It occurs predominantly in men, blacks and intravenous drug users (IVDU) in the USA, rarely in women, children, whites or people of other origin. HIVAN is a focal segmented glomerulosclerosis, characterized by nephrotic range proteinuria and rapid progression to end stage renal disease (ERSD). Its prognosis is poor. The case of a Greek patient with HIVAN and ERSD who has prolonged survival on a program of hemodialysis is described. A 30 year-old Greek homosexual man with AIDS (CD4 196/ mm3), receiving high active antiretroviral therapy (HAART), showed proteinuria and renal failure. Fifty four months after AIDS diagnosis, renal biopsy revealed HIVAN which was not responsive to a new antiretroviral regimen, angiotensin converting enzyme inhibitor and corticosteroids. Rapid progression to ERSD was followed by further immunosuppression and development of Pneumocyctis carinii pneumonia, which was treated by trimethoprim/ sulphamethoxazole, while corticosteroid therapy was discontinued. A chronic hemodialysis program was started and 35 months later the patient remains alive with a good quality of life. This interesting patient represents –to the best of our knowledge– the first case of HIVAN reported in the Greek literature.
Authors and Affiliations
A. KALOTERAKIS, S. BATZIOS, E. XYDIA, G. BOUGATSOS, I. KAKAVAS
Keywords
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