Resumen
La afectación del virus de la inmunodeficiencia humana (VIH) ha cambiado tras el inicio del tratamiento antirretroviral de gran actividad, ya que este ha generado una mayor supervivencia y un menor número de comorbilidades en los pacientes. Es común que en las personas con VIH el fracaso renal agudo esté asociado a sepsis, toxicidad por fármacos o afección directa por el propio virus. La nefropatía en pacientes con VIH es variada y puede estar asociada al uso de medicamentos o directamente al efecto del virus. La prevalencia de esta patología en este tipo de pacientes es <10 % y se caracteriza por un colapso glomerular. Las células del parénquima renal expresan los receptores de quimiocinas CCR5 y CXCR4, que son esenciales para la entrada de cepas de VIH-1 en las células. El presente caso es particularmente interesante ya que la insuficiencia renal aguda en el marco de un síndrome nefrótico fue la primera manifestación en un paciente con VIH/sida.
Citas
Balow JE. Nephropaty in the context of HIV infection. Kidney Int. 2005;67(4):1632- 3. https://dx.doi.org/10.1111/j.1523-1755.2005.00254.x
Williams DI, Williams DJ, Williams IG, Unwin RJ, Griffiths MH, Miller RF: Presentation, pathology and outcome of HIV associated renal disease in a specialist centre for HIV/AIDS. Sex Transm Inf 74:179-184, 1998. https://doi.org/10.1136/sti.74.3.179
Kimmel Pl, Barisoni L, Kopp JB: Pathogenesis and Treatment of HIV- Associated Renal Diseases: Lessons from Clinical and Animal Studies, Molecular Pathologic Correlations, and Genetic Investigations. Ann Intern Med. 139:214-227, 2003. https://doi.org/10.7326/0003-4819-139-3-200308050-00011
Rao TK, Filippone FJ, Nicastrti AD, Landesman SH, Frank E, Chen CK et al. Associated focal and segmental glomerulosclerosis in the acquired inmunodeficency syndrome. N Engl J Med 310 (11):669-73, 1984. https://doi.org/10.1056/NEJM198403153101101
Bruggeman LA, Ross MD, Tanji N, et al: Renal epithelium is a previously unrecognized site of HIV-1 infection, J Am Soc Nephrol 11: 2079-2087, 2000. https://doi.org/10.1681/ASN.V11112079
D'Agati V, Appel GB. HIV infection and the kidney. A review of the clinical features, course, pathogenesis, and treatment of HIV nephropathy. J Am Soc Nephrol.1997; 8:138-52. https://doi.org/10.1681/ASN.V81138
Donadío JV,Grande JP. Nefropatía IgA y SIDA. N Engl J Med.2002;347(191):738-48. https://doi.org/10.1056/NEJMra020109
Szckech L. Renal asociated with human inmunodeficiency virus infections: epidemiology, clinical course and managements. Clin Infect Dis. 2001;33:115-9. https://doi.org/10.1086/320893
Szczech LA, Hoover DR, Feldman JG, Cohen MH, Gange SJ, Gooze L,et al.Associationbetween renal disease and outcomes among HIV-infected women receiving or not receivingantiretroviral therapy. Clin Infect Dis, 2004;39(8):1199-206. http://dx.doi.org/10.1086/424013
Mocroft A, Kirk O, Gatell J, Reiss P, Gargalianos P, Zilmer K,et al. Chronic renal fai-lure among HIV-1-infected patients. AIDS. 2007;21(9):1119-27. https://dx.doi.org/10.1097/QAD.0b013e3280f774ee
Gupta SK, Mamlin BW, Johnson CS, Dollins MD, Topf JM, Dube MP. Prevalence of protei-nuria and the development of chronic kidney disease in HIV-infected patients. Clin Nephrol.2004;61(1):1-6. https://dx.doi.org/10.5414/cnp61001
Monahan M, Tanji N, Klotman PE. HIV-associated nephropathy: an urban epidemic. Se-min Nephrol. 2001;21(4):394-402. https://dx.doi.org/10.1053/snep.2001.23771
Klotman PE. HIV-associated nephropathy. Kidney Int, 1999;56(3):1161-76. http://dx.doi.org/10.1046/j.1523-1755.1999.00748.x
Trullàs JC, Barril G, Cofan F, Moreno A, Cases A, Fernández-Lucas M, et al; and the Spanish HIV Infection in Dialysis Study Group. Prevalence and clinical characteristics of HIV type 1-infected patients receiving dialysis in Spain: results of a Spanish survey in 2006: GESIDA 48/05 study. AIDS Res Hum Retroviruses. 2008; 24:1229-35. https://doi.org/10.1089/aid.2008.0158
Eitner F, Cui Y, Hudkins KL, Stokes MB, Segerer S, Mack S,et al. Chemokine Recep-tor CCR5 and CXCR4 Expression in HIV-associated Kidney Disease. J Am Soc Nephrol.2000;11(5):856-67
Haraouse JM, Kunsch C, Hartle HT, Laughlin MA, Hoxie JA, Wigdahl B, Gonzalez-Scarano F: CD4-independent infection of human neural cells by immunodeficiency virus type 1. J Virol 1989;63:2527-2533. https://doi.org/10.1128/jvi.63.6.2527-2533.1989
Singh, P. et al. Tubular cell HIV-entry through apoptosed CD4 T cells: a novel pathway. Virology 434, 68-77 (2012). https://doi.org/10.1016/j.virol.2012.09.009
Hatsukari, I. et al. DEC-205-mediated internalization of HIV-1 results in the establishment of silent infection in renal tubular cells. J. Am. Soc. Nephrol. 18, 780-787 (2007). https://doi.org/10.1681/ASN.2006121307
Marras D, Bruggeman LA, Gao F, Tanji N, Mansukhani MM, Cara A, Ross MD, Gusella GL, Benson G, D'Agati VD, Hahn BH, Klotman ME, Klotman PE: Replication and compartmentalization of HIV-1 in kidney epithelium of patients with HIV-associated nephropathy. Nat Med 2002;8:522-526. https://doi.org/10.1038/nm0502-522
Chen G, Paka L, Kako Y, Singhal P, Duan W, Pillarisetti S. A Protective Role for KidneyApolipoprotein E. Regulation of Mesangial Cell Proliferation and Matrix Expansion. J BiolChem. 2001;276(52):49142-7. https://dx.doi.org/10.1074/jbc.M104879200
Fine, D. M. et al. APOL1 risk variants predict histopathology and progression to ESRD in HIV-related kidney disease. J. Am. Soc. Nephrol. 23, 343-350 (2012). https://doi.org/10.1681/ASN.2011060562
Nichols, B. et al. Innate immunity pathways regulate the nephropathy gene apolipoprotein L1. Kidney Int. 87, 332-342 (2015). ). https://doi.org/10.1038/ki.2014.270
Dijkman HB, Weening JJ, Smeets B, Verrijp KC, Van Kuppevelt TH, Assmann KK,etal. Proliferating cells in HIV and pamidronate-associated collapsing focal segmental glo-merulosclerosis are parietal epithelial cells. Kidney Int, 2006;70(2):338-44. http://dx.doi.org/10.1038/sj.ki.5001574
Domingo P, Knobel H, Gutiérrez F, Barril G, Fulladosa X. Evaluación y tratamiento dela nefropatía en el paciente con infección por VIH-1. Una revisión práctica. Enferm InfeccMicrobiol Clin. 2010;28(3):185-98. https://dx.doi.org/10.1016/j.eimc.2009.05.004
Wyatt CM, Klotman PE, D’Agati VD. HIV-Associated Nephropathy: Clinical Presenta-tion, Pathology, and Epidemiology in the Era of Antiretroviral Therapy. Semin Nephrol.2008;28(6):513-22. https://dx.doi.org/10.1016/j.semnephrol.2008.08.005
Winston JA, Bruggeman LA, Ross MD, Jacobson J, Ross L, D’Agati VD,et al. Nephropathyand establishment of a renal reservoir of HIV type 1 during primary infection. N Engl J Med,2001;344(26):1979-84. https://dx.doi.org/10.1056/NEJM200106283442604
Cohen AH, Nast CC. Renal injury associated with human immunodeficiency virus infection. En: Jennette JC, Olson JL, Schwartz MM, Silva FG, editors. Heptinstall's pathology of the kidney. 6th ed. Philadelphia: Lippincott Williams & Wilkins; 2007. p. 397-422.
Bandera-Ramos Y, Ge Martínez PY, Bravo-Castillo L, Castillo-Hernández K, Torres-Rondón G. Prevalencia de enfermedad renal crónica en pacientes con síndrome de inmu-nodeciencia adquirida. MEDISAN. 2016 [citado mayo 23 de 2020];20(8):1022-9. Dispo-nible en: http://scielo.sld.cu/scielo.php?script=sciarttext&pid=S1029-30192016000800003&lng=es
Wei A, Burns GC, Williams BA, Mohammed NB, Visintainer P, Sivak SL. Long- termrenal survival in HIV-associated nephropathy with angiotensin-converting enzyme inhibi-tion. Kidney Int. 2003;64(4):1462-71. http://dx.doi.org/10.1046/j.1523-1755.2003.00230.x
Atta MG, Gallant JE, Rahman MH, Nagajothi N, Racusen LC, Scheel PJ, et al. Antiretro-viral therapy in the treatment of HIV-associated nephropathy. Nephrol Dial Transplant.2006;21(10):2809-13. http://dx.doi.org/10.1093/ndt/gfl337
Lucas GM, Eustace JA, Sozio S, Mentari EK, Appiah KA, Moore RD. Highly active antire-troviral therapy and the incidence of HIV-1-associated nephropathy: a 12-year cohort study.AIDS. 2004;18(3):541-6). https://dx.doi.org/10.1097/00002030-200402200-00022
Wali RK, Drachenberg CI, Papadimitriou JC, Keay S, Ramos E. HIV-1- associated neph-ropathy and response to highly-active antiretroviral therapy. Lancet, 1998;352(9130):783-4.http://dx.doi.org/10.1016/S0140-6736(98)24037-2

Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-SinDerivadas 4.0.
Derechos de autor 2020 Revista Colombiana de Nefrología