Renal manifestations of concurrent systemic lupus erythematosus and HIV infection.

TitleRenal manifestations of concurrent systemic lupus erythematosus and HIV infection.
Publication TypeJournal Article
Year of Publication1999
AuthorsChang BG, Markowitz GS, Seshan SV, Seigle RL, D'Agati VD
JournalAm J Kidney Dis
Date Published1999 Mar
KeywordsAcute Kidney Injury, Adult, Biopsy, Child, Child, Preschool, Female, Hematuria, HIV Infections, Humans, Kidney Diseases, Lupus Erythematosus, Systemic, Male, Proteinuria, Severity of Illness Index

Autoimmune phenomena are common in human immunodeficiency virus (HIV) infection, yet systemic lupus erythematosus (SLE) and HIV infection rarely are seen concurrently in the same patient. Many of the cases of combined HIV infection and SLE reported in the literature are patients with SLE before HIV infection and who did not undergo renal biopsy at a time when both processes were present. We report the clinical manifestations and renal biopsy findings in four subjects with concurrent HIV infection and SLE and compare them with the seven previously reported cases in the literature. Taken together, most patients were black (91%) and male (73%), and approximately half (55%) were children with perinatal HIV infection. These demographics differ markedly from those of idiopathic SLE, a disease that predominantly affects female adults. Renal presentations included proteinuria and hypocomplementemia, frequently with hematuria and renal insufficiency. Renal biopsy findings in 10 cases included all classes of lupus nephritis (class IIb in two cases, class III in one case, class IV in three cases, class V in three cases, class III and V in one case), two of which also displayed overlapping features of HIV-associated nephropathy (HIVAN). One case had isolated findings of HIVAN. This cohort provides a unique population in which to study interacting pathomechanisms between HIV infection and SLE.

Alternate JournalAm J Kidney Dis
PubMed ID10070907
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