Chronic HIV infection is associated with which typical nephropathy?

Ans. c (Collapsing variant of Focal Segmental glomerulosclerosis) (Ref. Robbin's 8th/555; Harrison's 17th/Ch. 277)Collapsing glomerulopathy is characterized by collapse of the entire glomerular tuft and podocyte hyperplasia. This is a more severe manifestation of FSGS that may be idiopathic or associated with HIV infection or drug-induced toxicities. It carries a particularly poor prognosis.HUMAN IMMUNODEFICIENCY VIRUS ASSOCIATED NEPHROPATHY# HIV-associated nephropathy is seen after an interval of approximately 2.5 years from discovery of HIV, and many patients have low CD4 counts.# Most lesions on renal biopsy show FSGS followed by MPGN. Other less common renal lesions include DPGN, IgA nephropathy, MCD, and membranous or mesangioproliferative glomerulonephritis.# The FSGS characteristically reveals collapse of the glomerular capillary tuft called collapsing glomerulopathy. visceral epithelial cell swelling, microcystic dilatation of renal tubules, and tubuloreticular inclusions.# MPGN and DPGN have been reported more commonly in HIV-infected Caucasians and in patients co-infected with hepatitis B or C. HIV-associated TTP has also been reported.# HIV with FSGS typically present with nephrotic-range proteinuria and hypoalbuminemia, but unlike patients with other causes for nephrotic syndrome, they do not have HTN, edema, or hyperlipidemia.# Rx with inhibitors of the renin-angiotensin system decreases the proteinuria.# Many feel that effective antiretroviral therapy benefits both the patient and the kidney.