HIV-associated immune complex kidney disease

Abstract

The aim of the study was to evaluate the clinical and morphological variants of immune complex kidney damage in patients with HIV-infection.

Material and methods. In 26 patients with HIV-infection, a histological examination of the renal tissue was performed. The clinical and morphological variants of glomerular damage to the kidneys of immune complex nature were studied. Morphological studies of biopsy specimens included light microscopy and immunofluorescence studies. An immunofluorescence study was performed on frozen sections using monoclonal FITC-labeled antibodies to IgG, IgM, IgA, C3 and C1q complement fragments (DAKO). All patients of the study group underwent immunological and virological blood tests (determination of antibodies to HIV by ELISA and immune blotting, the level of HIV RNA viremia by polymerase chain reaction, indicators of immune status by flow cytometry).

Results and discussion. In the examined HIV-infected patients immune complex glomerulonephritis was clinically characterized by nephrotic and/or acute nephritic syndrome in combination with hematuria. Arterial hypertension was detected in 14 (53.8%) of 26 patients. Chronic renal failure was established in 3 (11.5%) of 26 patients. Histological examination of renal tissue at the optic level revealed various morphological variants of proliferative glomerulonephritis. According to immunofluorescence data, luminescence of immune deposits containing immunoglobulins of IgA, IgM, IgG classes and fragments of the complement system (C3, C1q) in the absence of antinuclear factor and antibodies to native DNA in the blood was detected in 65.4% of cases, which made it possible to diagnose pseudo-lupus (lupus-like) jade. This variant of glomerular kidney damage in HIV infection is of scientific interest and requires further study.

Keywords:HIV-infection, Kidney biopsy, glomerulonephritis, lupus-like glomerulonephritis

Funding. The study had no sponsor support.

Conflict of interests. The authors declare no conflict of interests.

For citation: Yushchuk N.D., Gadzhikulieva M.M., Volgina G.V., Ivannikov E.V., Frolova N.F., Stolyarevich E.S. HIV-associated immune complex kidney disease. Infektsionnye bolezni: novosti, mneniya, obuchenie [Infectious Diseases: News, Opinions, Training]. 2020; 9 (2): 57-62. DOI: 10.33029/2305-3496-2020-9-2-57-62 (in Russian)

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CHIEF EDITOR
Aleksandr V. Gorelov
Academician of the Russian Academy of Sciences, MD, Head of Infection Diseases and Epidemiology Department of the Scientific and Educational Institute of Clinical Medicine named after N.A. Semashko ofRussian University of Medicine, Ministry of Health of the Russian Federation, Professor of the Department of Childhood Diseases, Clinical Institute of Children's Health named after N.F. Filatov, Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation, Deputy Director for Research, Central Research Institute of Epidemiology, Rospotrebnadzor (Moscow, Russian Federation)

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