《HIV感染背景下的肾脏疾病:KDIGO争议会议的结论》解读

    Interpretation of “Kidney Disease in the Setting of HIV Infection: Conclusions from a KDIGO Controversies Conference”

    • 摘要: 人类免疫缺陷病毒(human immunodeficiency virus,HIV)阳性患者罹患肾病的风险增加。随着治疗策略的改变,HIV阳性患者出现的肾病类型也从传统的HIV相关性肾病,扩展到HIV相关免疫性肾损伤,以及因长期接受抗逆转录病毒治疗或机会性感染造成的肾损伤。目前HIV阳性患者肾病的防治指南主要基于一般人群的研究,未充分纳入HIV相关独特发病途径和遗传因素。KDIGO组织于2017年召集国际肾脏病学、肾脏病理学和传染病专家,明确了HIV感染背景下肾脏疾病的病理分类,描述遗传学在HIV阳性患者发生肾病的病程和诊治中的作用,评估了抗逆转录病毒治疗用于HIV患者防治的肾病风险/效益,并初步确定HIV阳性患者肾脏疾病预防和管理的最佳做法。本文对此次会议内容进行初步介绍。

       

      Abstract: HIV-positive individuals are at increased risk of kidney disease. Following the shift of HIV treatment model, the spectrum of kidney diseases in the setting of HIV infection has extended from the classic HIV-associated nephropathy to immune complex nephropathy, and renal injury due to long-term antiretroviral therapy or opportunistic infection. Current guidelines for prevention and treatment of HIV-positive patients with kidney disease are based primarily on general population studies and do not fully incorporate existing knowledge of unique HIV pathways and genetic factors.KDIGO convened an international panel of experts in nephrology, renal pathology and infectious diseases to preliminarily determine the pathology of renal disease in the setting of HIV infection, to describe the role of genetics in the course, diagnosis and treatment of nephropathy in HIV-positive patients, to characterize the renal risk/benefit of antiretroviral therapy for the HIV prevention and treatment; to define the best practices for the prevention and management of kidney disease in HIV-positive patients.The comprehensive content of this conference was introduced here.

       

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