Abstract

NICOLAU LAPARRA, M.C. et al. Temporal evolution of renal involvement in a necropsy study of HIV patients from the pre and HAART eras. Nefrología (Madr.) [online]. 2010, vol.30, n.4, pp.420-426. ISSN 1989-2284.

Background:The aim of the present study is to analyze the impact of high activity antiretroviral therapy (HAART) on renal lesions observed in autopsies of HIV patients. Subjects and methods: Clinical records and renal pathologic samples from 100 HIV patients, who had died between 1984 and 2006, were reviewed, 61 before 1997 (group I) and 39 after. 24 of them had not received HAART (group II) and 15 had (group III). Premortem clinical and analytical data were obtained. Renal samples were stained with hematoxilin-eosin, PAS, Masson trichrome and silver-methenamine. Final pathologic diagnosis was recorded along with the findings at glomerular, tubular and interstitial levels. HIVAN was defined by the presence of focal or segmental glomerulosclerosis with glomerular collapse and microcystic tubulo-interstitial lesions. Results: The main causes of death were infections 68%, tumours 14%, and others 18%, especially liver diseases. Renal failure was present in 42% at the time of the dead. A predominance of tubular lesions exists in the three study groups. The main diagnoses were acute tubular necrosis (ATN) and septic nephritis. Four cases of HIVAN were found. In subjects under HAART more interstitial lesions have been observed. There were also more cases of acute tubular necrosis but these differences were not statistically significant. Conclusions: Renal lesions were frequent in HIV patients independent of the presence or the at absence of HAART.

Keywords : HIVAN; Renal lesion; Autopsic cohort; HIV.

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