Herman Elizabeth S, Klotman Paul E
Division of Nephrology, Mount Sinai Medical Center, New York, NY, USA.
Semin Nephrol. 2003 Mar;23(2):200-8. doi: 10.1053/snep.2003.50018.
Initially described in 1984, human immunodeficiency virus-associated nephropathy (HIVAN) has now become a common disease within the HIV-seropositive population. It is a focal segmental glomerulosclerosis causing rapid deterioration of renal function. It is the most common cause of chronic renal disease in HIV patients and occurs almost exclusively in blacks. Through murine and human studies, it is now clear that HIVAN is caused by a direct effect of infection of renal cells by HIV-1 and that the virus actively replicates within renal cells. How the virus causes disease within cells is not yet understood, but there is evidence for factors within infected cells causing both proliferation and apoptosis. Steroids, angiotensin converting enzyme (ACE) inhibitors, and highly active antiretroviral therapy (HAART) have been used for the treatment of HIVAN, with HAART, in particular, showing a dramatic improvement in both the pathologic changes and clinical course of HIVAN.
人类免疫缺陷病毒相关性肾病（HIVAN）于1984年首次被描述，如今已成为HIV血清阳性人群中的常见疾病。它是一种局灶节段性肾小球硬化症，可导致肾功能迅速恶化。它是HIV患者慢性肾病的最常见病因，几乎仅发生于黑人。通过小鼠和人体研究，现已明确HIVAN是由HIV-1感染肾细胞的直接作用所致，且该病毒在肾细胞内活跃复制。病毒如何在细胞内引发疾病尚不清楚，但有证据表明受感染细胞内的因素会导致增殖和凋亡。类固醇、血管紧张素转换酶（ACE）抑制剂和高效抗逆转录病毒疗法（HAART）已用于治疗HIVAN，尤其是HAART，在HIVAN的病理变化和临床病程方面均显示出显著改善。
