HIV-Associated Nephropathy (HIVAN)

1. Know the characteristics of HIVAN at the level of light microscopy

   • Glomeruli

• FSG w/ hyalinosis

• Collapse of capillaries around mesangia

• Swelling of epithelial cells w/ accumulation of hyaline droplets in cytoplasm

• Dilation of capsular space containing cast-like material

• Tubule

• Dilation, flattening of epithelium, hyaline droplets, necrosis

• Eosinophillic casts containing IgA, IgG, IgM, complement, albumin, kappa, and lambda, No Tamm-Horsfall protein. Scalloped appearance at periphery of casts

• Interstitial nephritis

2. Both HAN and HIVAN show focal segmental glomerulosclerosis. What are the differences between HAN and HIVAN clinically and at the level of electonmicroscopy?

   • Tubular reticular inclusions are commonly seen in endothelial cells

   • Cylindrical confronting cysternae in lymphocytes, macrophages, and endothelial cells

3. Know the prevalence of HIVAN in different groups of patients

   • More frequent in blacks and drug abusers

Category: Pathology Notes