Kanzaki Go, Tsuboi Nobuo, Miyazaki Yoichi, Yokoo Takashi, Utsunomiya Yasunori, Hosoya Tatsuo
Division of Kidney and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Japan.
Intern Med. 2012;51(12):1543-8. doi: 10.2169/internalmedicine.51.7093. Epub 2012 Jun 15.
This report presents a human immunodeficiency virus (HIV) patient that developed a slowly progressive renal impairment over years under highly active antiretroviral therapy (HAART). The renal biopsy showed diffuse tubulointerstitial nephritis accompanied by crystal formations that were surrounded by multinuclear giant cells. Furthermore, rod-like crystals were detected in the urinary sediments. Tenofovir and Atazanavir were thought to be the causative drugs for the renal injury. Therefore, the possibility of HARRT-induced nephrotoxicity should be considered in HIV-infected patients, even though the activity of HIV is controlled by such therapies.
本报告介绍了一名人类免疫缺陷病毒（HIV）患者，该患者在高效抗逆转录病毒疗法（HAART）下多年来出现了缓慢进展的肾功能损害。肾活检显示弥漫性肾小管间质性肾炎，并伴有被多核巨细胞包围的晶体形成。此外，在尿沉渣中检测到棒状晶体。替诺福韦和阿扎那韦被认为是导致肾损伤的药物。因此，即使HIV的活性通过此类疗法得到控制，在HIV感染患者中也应考虑HAART引起肾毒性的可能性。
