26th June 2023

HIV associated nephropathy (HIVAN)

Renal dysfunction has been described in association with HIV infection; this can be due to HIV associated glomerulonephritis, HIV associated thrombotic microangiopathy, or secondary to antiretroviral medication nephrotoxicity.

The most common histological abnormality in HIVAN is focal segmental glomerulosclerosis or FSGS, present in over 80% of cases. Clinically, this presents with proteinuria in the nephrotic range and oedema, Hypertension and haematuria are uncommon. Over 90% of patients with HIVAN are black. If untreated, patients can go on to develop rapidly progressive chronic kidney disease. Highly active antiretroviral therapy (HAART) may result in the stabilisation of renal function and the prevention of progression to end stage renal failure.