Dr Gan Kian Seong Selayang Malaysia

1. HIV and The Kidney 13/2/07

2. Types of HIV-associated glomerular nephropathies Endothelial cell injury (apoptosis, infection) Glomerular microangiopathy, mesangiolysis 2–10 HIV-associated thrombotic microangiopathy HIV-associated immune complexes deposition, co-infections associated immune complexes deposition (HBV, HCV, intravenous drug use) Membranoproliferative GN, membranous nephropathy, IgA nephropathy, 'lupus like nephropathy', 20–50 HIV-associated immune complexes nephropathy HIV infection of renal cells (epithelial tubular cells, podocytes, mesangial cells) Focal glomerular sclerosis, 'collapsing nephropathy' Tubular atrophy, microcystic dilatation 40–80 HIV-associated nephropathy (HIVAN) Proposed pathogenetic links Histological renal lesions Average freq (%) Types of HIV associated glomerular nephropathies

11. Collapsing glomerulosclerosis: light microscopy showing few open loops, large urinary space in glomerulus and severe tubulointerstitial injury with microcyst formation and tubular degeneration

12. Electron microscopy show tubular reticular inclusions in endothelial cells which is thought to be induced by IFN-a (also in SLE)

41. MAJOR RECOMMENDATIONS

45. Thank You