HIV-associated nephropathy (HIVAN) is a type of kidney disease that occurs in patients who are infected with the human immunodeficiency virus (HIV). HIVAN is characterized by high levels of protein in the urine, high levels of nitrogenous (waste) products in the blood, and scarring or hardening of blood vessels in the kidneys (focal segmental glomerulosclerosis). Patients with HIVAN often suffer from symptoms such as increased urination, excessive thirst, and fatigue.
The kidneys, which are a pair of organs located on the left and right side of the abdomen, are an essential component of the urinary tract. They remove toxins, chemicals, and waste products from the blood. They also regulate acid concentration and maintain water and electrolyte balance in the body by excreting urine.
HIVAN occurs when the HIV virus infects cells inside the kidneys or the medications used to treat HIV damage kidney cells. When the cells become damaged, the kidneys do not function properly and symptoms of HIVAN develop.
Prognosis of HIVAN patients varies. If the condition is left untreated, it can lead to kidney failure and possibly death. According to the U.S. Renal Data System (USRDS), HIVAN accounts for about one percent of new end-stage renal disease (ESRD, also called kidney failure) cases in the United States. HIVAN is the third leading cause of ESRD among African Americans ages 20-64 years old. An estimated 90% of HIVAN patients are African American. It is unknown exactly why African Americans are predisposed to kidney disease. About half of African Americans with HIVAN are injection drug users. It is believed that injection drug use damages the kidneys, making drug addicts more vulnerable to developing kidney disease.
However, if diagnosed and treated early, HIVAN is curable.
If HIV is infecting kidney cells and causing damage, patients receive a combination of anti-HIV drugs, called highly active antiretroviral therapy (HAART). This suppresses the viruses and, in most cases, kidney damage is reversed. If HIV medications are responsible for the kidney damage, a healthcare provider may recommend alternative drugs or doses.
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