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HIV kidney disease

Luis J Jara, Gabriela Medina, Miguel A Saavedra
PURPOSE OF REVIEW: To provide an update about the interactions between infections and autoimmune diseases (AIDs), from the molecular perspective to the clinical spectrum and the differentiation between infection and disease activity. RECENT FINDINGS: Any kind of infection may modify the innate and adaptive immune response through the following mechanisms: molecular mimicry, superantigens, epitope spreading and B-cell activation. The consequence is the overproduction of antibodies shared with those found in AIDs...
March 9, 2018: Current Opinion in Rheumatology
Jens D Lundgren, Alvaro H Borges, James D Neaton
PURPOSE OF REVIEW: Optimal control of HIV can be achieved by early diagnosis followed by the initiation of antiretroviral therapy (ART). Two large randomised trials (TEMPRANO and START) have recently been published documenting the clinical benefits to HIV-positive adults of early ART initiation. Main findings are reviewed with a focus on serious non-AIDS (SNA) conditions. RECENT FINDINGS: Data from the two trials demonstrated that initiating ART early in the course of HIV infection resulted in marked reductions in the risk of opportunistic diseases and invasive bacterial infections...
March 5, 2018: Current HIV/AIDS Reports
Dian Peng, Bin Cao, Ying-Jun Zhou, Ya-Qiu Long
The CXC chemokine receptor 4 (CXCR4) is a highly reserved G-protein coupled 7-transmembrane (TM) chemokine receptor which consists of 352 amino acids. CXCR4 has only one endogenous chemokine ligand of CXCL12, besides several other natural nonchemokine ligands such as extracellular ubiquitin and noncognate ligand of MIF. CXCR4 strongly binds to CXCL12 and the resulting CXCLl2/CXCR4 axis is the molecular basis of their various biological functions, which include: (1) mediating immune and inflammatory response; (2) regulation of hematopoietic stem cell migration and homing; (3) an essential co-receptor for HIV entry into host cells; (4) participation in the process of embryonic development; (5) malignant tumor invasion and metastasis; (6) myocardial infarction, ischemic stroke and acute kidney injury...
February 17, 2018: European Journal of Medicinal Chemistry
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March 13, 2018: AIDS
Carmen Fontela, Jesús Castilla, Regina Juanbeltz, Iván Martínez-Baz, María Rivero, Aisling O'Leary, Natalia Larrea, Ramón San Miguel
OBJECTIVES: The increased survival of HIV-infected individuals has resulted in a premature aging of this population, with the consequent development of premature age-related comorbidities and risk factors. We aimed to describe the prevalence of age-related comorbidities and cardiovascular risk factors in older adults with HIV infection on antiretroviral therapy (ART). METHODS: A retrospective cross-sectional study was undertaken in a cohort of HIV patients aged ≥50 years on ART in September 2016 in Spain...
February 28, 2018: Postgraduate Medicine
Hortensia Álvarez, Ana Mariño, Nieves Valcarce, Saye Khoo, Sanjay Bhagani, Jonathan Schapiro, Josep M Llibre
Curing hepatitis C virus (HCV) infection in patients harbouring multiple severe comorbidities is a medical challenge. Evidence-based data are lacking regarding HCV treatment with direct-acting antiviral regimens in particular populations of HCV/HIV-coinfected patients with cirrhosis and chronic kidney disease on haemodialysis. Here, we present the HCV treatment challenges facing a patient with HIV coinfection, prior failure of both HIV-1 and HCV therapy, cirrhosis, end-stage renal failure on haemodialysis, as well as management of drug-drug interactions, especially given the need to receive long-term amiodarone therapy...
January 1, 2018: International Journal of STD & AIDS
Kerry A McBrien, Noah Ivers, Lianne Barnieh, Jacob J Bailey, Diane L Lorenzetti, David Nicholas, Marcello Tonelli, Brenda Hemmelgarn, Richard Lewanczuk, Alun Edwards, Ted Braun, Braden Manns
BACKGROUND: People with chronic diseases experience barriers to managing their diseases and accessing available health services. Patient navigator programs are increasingly being used to help people with chronic diseases navigate and access health services. OBJECTIVE: The objective of this review was to summarize the evidence for patient navigator programs in people with a broad range of chronic diseases, compared to usual care. METHODS: We searched MEDLINE, EMBASE, CENTRAL, CINAHL, PsycINFO, and Social Work Abstracts from inception to August 23, 2017...
2018: PloS One
Hubert Kouame Yao, Serge Didier Konan, Sindou Sanogo, Sery Patrick Diopoh, Amadou Demba Diallo
Chronic kidney disease (CKD) has become a public health problem because of its increasing prevalence. The objective of this study was to describe the current profile of CKD in our working conditions. This is a descriptive retrospective study of patients admitted for CKD during the period from January 2010 to December 2014 in the Internal Medicine Department of the university hospital of Treichville in Abidjan. CKD was defined by a glomerular filtration rate below 60 mL/min lasting for at least three months...
January 2018: Saudi Journal of Kidney Diseases and Transplantation
Steve Innes, Kunjal Patel
PURPOSE OF REVIEW: Perinatally HIV-infected adolescents may be at increased risk of noninfectious comorbidities later in life. This review summarizes recent advances in the understanding of noncommunicable diseases (NCD) among HIV-infected adolescents in high-income and lower middle-income countries, and identifies key questions that remain unanswered. We review atherosclerotic vascular disease (AVD), chronic bone disease (CBD), chronic kidney disease (CKD), and chronic lung disease (CLD)...
February 8, 2018: Current Opinion in HIV and AIDS
Stanislas Pol, Lucia Parlati
BACKGROUND & AIMS: The recommended combination of pangenotypic direct-acting antivirals (DAAs) for the treatment of hepatitis C virus (HCV) associates the co-formulation of 2 or 3 second-generation DAAs. In the so-called "special populations" defined as patients with chronic kidney disease (CKD), HCV/HIV co-infection, HCV/HBV co-infection and an unsuccessful previous DAA regimen, these combinations have a high antiviral potency (sustained virologic response (SVR) > 95%), fair tolerance and a reduced pill burden...
February 2018: Liver International: Official Journal of the International Association for the Study of the Liver
Nathan Calabro, Kammi Henriksen, Seah H Lim, Eric Kerns
We report a case of glomerular basement membrane crescentic glomerulonephritis and multicentric Castleman disease-associated interstitial nephritis in a patient with human immunodeficiency virus (HIV) infection. The patient received corticosteroids, cyclophosphamide, and plasmapheresis, and within 3 weeks, there was worsening thrombocytopenia, anemia, and renal function requiring initiation of hemodialysis. He then received 8 weekly doses of rituximab, and there was steady improvement in renal function, such that he stopped dialysis within 6 weeks and has remained in disease remission at 1-year follow-up...
February 9, 2018: Clinical Nephrology
Kim Peterson, Johanna Anderson, Erin Boundy, Lauren Ferguson, Ellen McCleery, Kallie Waldrip
BACKGROUND: Continued racial/ethnic health disparities were recently described as "the most serious and shameful health care issue of our time." Although the 2014 US Affordable Care Act-mandated national insurance coverage expansion has led to significant improvements in health care coverage and access, its effects on life expectancy are not yet known. The Veterans Health Administration (VHA), the largest US integrated health care system, has a sustained commitment to health equity that addresses all 3 stages of health disparities research: detection, understanding determinants, and reduction or elimination...
March 2018: American Journal of Public Health
Kimberly J Reidy, Rebecca Hjorten, Rulan S Parekh
PURPOSE OF REVIEW: Understanding the genetic risk of APOL1 in children and young adults is important given the lifetime risk of hypertension and kidney disease among children of African descent. We review recent epidemiologic and biologic findings on the effects of APOL1 and kidney disease. RECENT FINDINGS: APOL1 in children and young adults is associated with hypertension, albuminuria and more rapid decline in kidney function and progression to end-stage kidney disease, especially among those with glomerular causes of kidney disease, and those affected by sickle cell disease or HIV...
February 5, 2018: Current Opinion in Pediatrics
Charles R Swanepoel, Mohamed G Atta, Vivette D D'Agati, Michelle M Estrella, Agnes B Fogo, Saraladevi Naicker, Frank A Post, Nicola Wearne, Cheryl A Winkler, Michael Cheung, David C Wheeler, Wolfgang C Winkelmayer, Christina M Wyatt
HIV-positive individuals are at increased risk for kidney disease, including HIV-associated nephropathy, noncollapsing focal segmental glomerulosclerosis, immune-complex kidney disease, and comorbid kidney disease, as well as kidney injury resulting from prolonged exposure to antiretroviral therapy or from opportunistic infections. Clinical guidelines for kidney disease prevention and treatment in HIV-positive individuals are largely extrapolated from studies in the general population, and do not fully incorporate existing knowledge of the unique HIV-related pathways and genetic factors that contribute to the risk of kidney disease in this population...
February 2, 2018: Kidney International
William R Cooke, Ulla K Hemmilä, Alison L Craik, Chimwemwe J Mandula, Priscilla Mvula, Ausbert Msusa, Gavin Dreyer, Rhys Evans
BACKGROUND: Obstetric-related acute kidney injury (AKI) is thought to be a key contributor to the overall burden of AKI in low resource settings, causing significant and preventable morbidity and mortality. However, epidemiological data to corroborate these hypotheses is sparse. This prospective observational study aims to determine the incidence, aetiology and maternal-fetal outcomes of obstetric-related AKI in Malawi. METHODS: Women greater than 20 weeks gestation or less than 6 weeks postpartum admitted to obstetric wards at a tertiary hospital in Blantyre, Malawi, and at high-risk of AKI were recruited between 21st September and 11th December 2015...
February 2, 2018: BMC Nephrology
Mikaela Smit, Jack Olney, Nathan P Ford, Marco Vitoria, Simon Gregson, Anna Vassall, Timothy B Hallett
OBJECTIVES: We aim to characterise the future noncommunicable disease (NCD) burden in Zimbabwe to identify future health system priorities. METHODS: We developed an individual-based multidisease model for Zimbabwe, simulating births, deaths, infection with HIV and progression, and key NCD (asthma, chronic kidney disease (CKD), depression, diabetes, hypertension, stroke, breast, cervical, colorectal, liver, oesophageal, prostate and all other cancers). The model was parameterised using national and regional surveillance and epidemiological data...
January 23, 2018: AIDS
Carmine Rossi, Sahar Saeed, Joseph Cox, Marie-Louise Vachon, Valérie Martel-Laferrière, Sharon L Walmsley, Curtis Cooper, M John Gill, Mark Hull, Erica E M Moodie, Marina B Klein
OBJECTIVE: To examine the impact of sustained virologic response (SVR) and illicit (injection and non-injection) drug use on kidney function among hepatitis C virus (HCV) and HIV co-infected individuals. DESIGN: Longitudinal observational cohort study of HCV-HIV co-infected patients. METHODS: Data from 1,631 patients enrolled in the Canadian Co-Infection Cohort between 2003 and 2016 were analyzed. Patients who achieved SVR were matched 1:2 with chronically infected patients using time-dependent propensity scores...
January 23, 2018: AIDS
Joana Gameiro, Sofia Jorge, José A Lopes
The presence of human immunodeficiency virus (HIV)-related kidney disease is an important cause of mortality and morbidity. HIV infection induces renal injury by direct cytotoxicity or immune complex-mediated glomerulonephritis in patients with genetic susceptibility factors. In the last decades, with the development and diffusion of combination antiretroviral therapy, which has prolonged patient survival, there has been a shift in the spectrum of renal diseases in HIV-infected patients, with the decrease of glomerular diseases and increase in the role of nephrotoxicity and co-morbidities...
January 1, 2018: International Journal of STD & AIDS
Rhys D R Evans, William Cooke, Ulla Hemmila, Viviane Calice-Silva, Jochen Raimann, Alison Craik, Chimwemwe Mandula, Priscilla Mvula, Ausbert Msusa, Gavin Dreyer, Nathan W Levin, Roberto Pecoits-Filho
Introduction: Obstetric-related acute kidney injury (AKI) is associated with adverse outcomes for mother and fetus, particularly in low-income countries. However, laboratory-independent tools to facilitate diagnosis are lacking. We assessed the diagnostic performance of a salivary urea nitrogen (SUN) dipstick to detect obstetric-related acute kidney disease in Malawi. Methods: Women at high risk for AKI admitted to an obstetric unit in Blantyre, Malawi, were recruited between 21 September and 11 December 2015...
January 2018: KI Reports
Jean Hou, Cynthia C Nast
PURPOSE OF REVIEW: Human immunodeficiency virus (HIV)-associated nephropathy (HIVAN) was identified as the major renal manifestation of HIV infection early in the HIV epidemic. However, HIV infection now is associated with a different spectrum of renal lesions leading to chronic kidney disease. This review examines the changes in kidney injury occurring in the current HIV era and the factors involved in this transformation of disease expression. RECENT FINDINGS: The incidence of HIVAN and opportunistic infections in HIV-infected individuals has declined in concert with the use of effective combination antiretroviral agents...
January 13, 2018: Current Opinion in Nephrology and Hypertension
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