Pardo V, Meneses R, Ossa L, Jaffe D J, Strauss J, Roth D, Bourgoignie J J
Kidney Int. 1987 May;31(5):1167-73. doi: 10.1038/ki.1987.124.
The histopathology and incidence of AIDS-related glomerulopathy was evaluated by renal biopsy (N = 24) or at autopsy in 159 patients, including 131 adults and 28 infants and children with AIDS. Thirty-five patients had overt clinical manifestations of renal disease characterized by a nephrotic syndrome with focal and segmental glomerular sclerosis (FSS). Fifteen patients had diffuse glomerular mesangial hyperplasia (MH) without or with minimal clinical renal disease and 109 had intact or minimally involved glomeruli. Whereas 15 of 30 (50%) i.v. drug users with AIDS had evidence of renal disease, only one of 53 (2%) homosexuals had clinical renal disease and only 6 (11%) had histologic evidence of glomerular pathology. The study confirms the important risk of i.v. drug use as a pathogenic factor of renal disease and shows a rarity of renal disease in homosexual or bisexual men with AIDS. On the other hand, 30% of adult Haitians with AIDS had FSS or diffuse MH, although i.v. drug use is not an important risk factor in this population. Moreover, eight of 28 (29%) children with perinatal AIDS had evidence of renal involvement, including four with a nephrotic syndrome and FSS. The data provide strong evidence for the existence of an AIDS-related glomerulopathy independent of i.v. drug use, but suggest that unrecognized co-factors may be important in the development of renal disease.
通过肾活检（N = 24）或尸检对159例患者的艾滋病相关肾小球病的组织病理学及发病率进行了评估，其中包括131例成人以及28例患艾滋病的婴幼儿和儿童。35例患者有明显的肾脏疾病临床表现，其特征为肾病综合征伴局灶节段性肾小球硬化（FSS）。15例患者有弥漫性肾小球系膜增生（MH），无临床肾脏疾病或仅有轻微临床肾脏疾病，109例患者的肾小球完整或仅有轻微病变。30例患艾滋病的静脉吸毒者中有15例（50%）有肾脏疾病证据，而53例同性恋者中只有1例（2%）有临床肾脏疾病，只有6例（11%）有肾小球病理组织学证据。该研究证实了静脉吸毒作为肾脏疾病致病因素的重大风险，并显示患艾滋病的同性恋或双性恋男性中肾脏疾病罕见。另一方面，30%患艾滋病的成年海地人有FSS或弥漫性MH，尽管静脉吸毒在该人群中不是一个重要的风险因素。此外，28例围生期患艾滋病的儿童中有8例（29%）有肾脏受累证据，其中4例有肾病综合征和FSS。这些数据为存在独立于静脉吸毒的艾滋病相关肾小球病提供了有力证据，但表明未被认识的协同因素在肾脏疾病的发生发展中可能很重要。
