Last update:
24-Mar-2005

HIV-associated nephropathy (HIVAN) is the most common renal disease in HIV-infected patients. It occurs predominantly in men, blacks and intravenous drug users (IVDU) in the USA, rarely in women, children, whites or people of other origin. HIVAN is a focal segmented glomerulosclerosis, characterized by nephrotic range proteinuria and rapid progression to end stage renal disease (ERSD). Its prognosis is poor. The case of a Greek patient with HIVAN and ERSD who has prolonged survival on a program of hemodialysis is described. A 30 year-old Greek homosexual man with AIDS (CD4 196/mm³), receiving high active antiretroviral therapy (HAART), showed proteinuria and renal failure. Fifty four months after AIDS diagnosis, renal biopsy revealed HIVAN which was not responsive to a new antiretroviral regimen, angiotensin converting enzyme inhibitor and corticosteroids. Rapid progression to ERSD was followed by further immunosuppression and development of Pneumocyctis carinii pneumonia, which was treated by trimethoprim/sulphamethoxazole, while corticosteroid therapy was discontinued. A chronic hemodialysis program was started and 35 months later the patient remains alive with a good quality of life. This interesting patient represents –to the best of our knowledge– the first case of HIVAN reported in the Greek literature.

Key words: AIDS, Focal segmental glomerulosclerosis, Hemodialysis, HIV-associated nephropathy, Nephrotic syndrome.