Mount Sinai School of Medicine, New York, NY 10029, USA.
Adv Chronic Kidney Dis. 2010 Jan;17(1):36-43. doi: 10.1053/j.ackd.2009.08.012.
HIV-associated nephropathy (HIVAN) is one of the leading causes of ESRD in HIV-1-seropositive patients. Patients typically present with heavy proteinuria and chronic renal failure with pathologic findings of collapsing focal segmental glomerulosclerosis (FSGS). The disease is caused by direct infection of renal epithelial cells by HIV-1 in a genetically susceptible host. The genetic factors responsible for the susceptibility to HIVAN among blacks include a noncoding variant in the podocyte-expressed gene nonmuscle myosin, heavy chain 9 (MYH9) as well as other genes yet to be identified. Podocyte and tubular dysfunction results from the expression of viral genes, in particular nef and vpr, and the subsequent dysregulation of numerous host factors, including critical signaling pathways, inflammatory mediators, and others. The identification of these factors has the potential to provide novel therapeutic targets to prevent and treat this important disease.
HIV 相关性肾病（HIVAN）是 HIV-1 血清阳性患者终末期肾病的主要原因之一。患者通常表现为大量蛋白尿和慢性肾衰竭，病理表现为局灶性节段性肾小球硬化（FSGS）的塌陷。该疾病是由 HIV-1 直接感染肾小管上皮细胞引起的，在遗传易感宿主中。黑人中导致 HIVAN 易感性的遗传因素包括足细胞表达基因非肌肉肌球蛋白重链 9（MYH9）中的非编码变异以及其他尚未确定的基因。足细胞和肾小管功能障碍是由病毒基因的表达引起的，特别是 nef 和 vpr，以及随后宿主因子的失调，包括关键信号通路、炎症介质和其他。这些因素的鉴定有可能为预防和治疗这一重要疾病提供新的治疗靶点。
