Schmid Simone, Opravil Milos, Moddel Michael, Huber Milo, Pfammatter Rahel, Keusch Gerald, Ambuhl Patrice, Wuthrich Rudolf P, Moch Holger, Varga Zsuzsanna
Department of Pathology, Institute of Surgical Pathology, University Hospital Zurich, Schmelzbergstrasse 12, CH-8091 Zurich, Switzerland.
Virchows Arch. 2007 Jun;450(6):665-70. doi: 10.1007/s00428-007-0418-3. Epub 2007 Apr 27.
We performed a retrospective analysis on kidney biopsies of 30 human immunodeficiency virus (HIV)-positive patients. Twenty-two of them received highly active antiretroviral therapy (HAART). Tenofovir containing HAART together with atazanavir, a new protease inhibitor, was administered to three patients. All of them developed acute renal failure. The kidney biopsies of these patients showed an acute interstitial nephritis or a chronic interstitial nephritis with an acute component. Withdrawal of atazanavir and tenofovir resulted in recovery of renal function in all three patients. Acute interstitial nephritis was observed only in 1 of 19 patients without atazanavir or tenofovir treatment. We conclude that acute interstitial nephritis and consecutive acute renal failure is a relevant side effect of atazanavir and tenofovir therapy in HIV-positive patients.
我们对30例人类免疫缺陷病毒（HIV）阳性患者的肾活检进行了回顾性分析。其中22例接受了高效抗逆转录病毒治疗（HAART）。3例患者接受了含替诺福韦的HAART联合新型蛋白酶抑制剂阿扎那韦治疗。他们均出现了急性肾衰竭。这些患者的肾活检显示为急性间质性肾炎或伴有急性成分的慢性间质性肾炎。停用阿扎那韦和替诺福韦后，所有3例患者的肾功能均恢复。在未接受阿扎那韦或替诺福韦治疗的19例患者中，仅1例观察到急性间质性肾炎。我们得出结论，急性间质性肾炎及随后的急性肾衰竭是HIV阳性患者接受阿扎那韦和替诺福韦治疗的一种相关副作用。
