Bertoldi Alessia, De Crignis Elisa, Miserocchi Anna, Bon Isabella, Musumeci Giuseppina, Longo Serena, D'Urbano Vanessa, La Manna Gaetano, Calza Leonardo, Re Maria Carla
Microbiology Section, Department of Experimental, Diagnostic and Specialty Medicine, School of Medicine, University of Bologna, Italy.
Department of Biochemistry, Erasmus Medical Center, Rotterdam, The Netherlands.
New Microbiol. 2017 Jan;40(1):1-10.
Kidney disease represents an important health concern among HIV-infected individuals, with an estimated prevalence ranging between 2.4 and 17%. The widespread use of antiretroviral drugs has changed the epidemiology of kidney disease in the HIV positive population, drastically reducing the percentage of patients affected by HIV-associated nephropathy (HIVAN), a complication characterized by apoptosis and de-differentiation of renal epithelial cells and podocytes. However, impaired kidney function remains an important issue among HIV-infected patients because of their long-term exposure to antiretroviral drugs and the growing burden of traditional risk factors associated with chronic renal disease. Furthermore, since HIV infects renal epithelial cells, kidney is a potential reservoir site that needs to be considered in future eradication studies. This review summarizes the main risk factors associated with chronic kidney disease in HIV-infected patients and discusses the contribution of viral infection and antiretroviral therapy to the pathogenesis of renal damage, emphasizing the need to monitor kidney status during the follow-up of HIV-infected patients.
肾脏疾病是HIV感染者中的一个重要健康问题，估计患病率在2.4%至17%之间。抗逆转录病毒药物的广泛使用改变了HIV阳性人群中肾脏疾病的流行病学，大幅降低了受HIV相关性肾病（HIVAN）影响的患者比例，HIVAN是一种以肾上皮细胞和足细胞凋亡及去分化为特征的并发症。然而，由于HIV感染者长期接触抗逆转录病毒药物以及与慢性肾病相关的传统危险因素负担不断增加，肾功能受损仍然是一个重要问题。此外，由于HIV感染肾上皮细胞，肾脏是未来根除研究中需要考虑的潜在储存部位。本综述总结了HIV感染者慢性肾病的主要危险因素，并讨论了病毒感染和抗逆转录病毒治疗对肾损伤发病机制的作用，强调在HIV感染者随访期间监测肾脏状况的必要性。
