Korean J Nephrol.  2007 Nov;26(6):740-743.

A Case of Membranous Glomerulonephritis in a Patient with HIV Infection

• Kim JS
• Yang JW
• Kim MS
• Han ST
• Kim BR
• Kim HY
• Han BG
• Choi SO

Abstract

Viral infections can be causative in many glomerular disease, and human immunodeficiency virus (HIV) infection is closely related to a collapsing focal segmental glomerulosclerosis (FSGS). This is known as HIV associated nephropathy (HIVAN) and is characterized clinically by proteinuria, often of sudden onset, with rapidly progressive renal dysfunction resulting in end stage renal disease (ESRD) over several months. Increasingly, other primary renal diseases are being described in HIV infected patients, including IgA nephropathy, an immune complex lupus-like neprhopathy, and tubulonephritis. We observed rare HIVAN case presenting membranous glomerulonephritis with nephrotic syndrome in a woman who was positive for HIV without hepatitis B viral infection. She was treated with Methylprednisolone 60 mg/day, zidovudine 600 mg/day, efavirenz 60 mg/day, and lamivudine 300 mg/day for 5 months. After treatment, proteinuria decreased from 4,092 mg/day to 419 mg/day and CD4 T cell count rose from 594/mL to 1,176/mL. The effectiveness and safety of corticosteroids in the treatment of HIVAN remained controversial but this case showed good response for steroid with triple antiviral therapy about HIVAN especially membranous glomerulonephritis.

Keyword

HIV infection; HIV associated nephropathy; Membranous glomerulonephritis

MeSH Terms

Adrenal Cortex Hormones
AIDS-Associated Nephropathy
Antigen-Antibody Complex
Cell Count
Female
Glomerulonephritis, IGA
Glomerulonephritis, Membranous*
Glomerulosclerosis, Focal Segmental
Hepatitis B
HIV Infections*
HIV*
Humans
Kidney Failure, Chronic
Lamivudine
Methylprednisolone
Nephrotic Syndrome
Proteinuria
Zidovudine
Adrenal Cortex Hormones
Antigen-Antibody Complex
Lamivudine
Methylprednisolone
Zidovudine