The Evolution of Our Knowledge of HIV-Associated Kidney Disease in Africa
| Autor: | Nicola Wearne, Ikechi G. Okpechi, Charles R. Swanepoel, Maureen Duffield |
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| Rok vydání: | 2012 |
| Předmět: |
Kidney Glomerulus
Prevalence HIV Infections Nephropathy Pharmacotherapy medicine Humans AIDS-Associated Nephropathy Socioeconomic status Africa South of the Sahara business.industry Incidence Incidence (epidemiology) Acute kidney injury Acute Kidney Injury History 20th Century Kidney Tubular Necrosis Acute medicine.disease Anti-Retroviral Agents Nephrology Africa Immunology HIV-1 Drug Therapy Combination Health Expenditures business Demography Kidney disease |
| Zdroj: | American Journal of Kidney Diseases. 60:668-678 |
| ISSN: | 0272-6386 |
| DOI: | 10.1053/j.ajkd.2012.04.034 |
| Popis: | Human immunodeficiency virus (HIV) infection started in Africa circa 1930. South Africa has the highest prevalence rate in the world. Although reports of HIV-associated nephropathy (HIVAN) appeared in the early 1980s, the earliest report from sub-Saharan Africa (SSA) came in 1994. Geographical, socioeconomic, political, and ethical factors have worked in concert to shape the character of HIV disease as it is seen in SSA. Political leaders within SSA have, through their actions, significantly contributed to the incidence of HIV infection. Black females, who often face cultural suppression and disadvantage, have a higher prevalence of HIV than males. Too few studies and outcomes data have bedeviled the statistics in SSA in relation to HIVAN prevalence and its management. Much of what is written is approximation and anecdotal. The largest reliable biopsy series comes from the University of Cape Town, where a workable classification of HIVAN has been developed to enable standardization of terminology. Histologic and clinical prognostic indicators with outcomes have been evaluated using this classification. Patients with HIV who present with acute kidney injury appear to have mainly acute tubular necrosis due to sepsis, dehydration, and nephrotoxic drugs. Since the rollout of combination antiretroviral therapy, the extent of HIV infection and kidney disease continues to be modified and possibly retarded. |
| Databáze: | OpenAIRE |
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