Document 0665
 DOCN  M9440665
 TI    HIV-associated immune-mediated renal disease.
 DT    9404
 AU    Kimmel PL; Phillips TM; Ferreira-Centeno A; Farkas-Szallasi T; Abraham
       AA; Garrett CT; Department of Medicine, George Washington University
       Medical; Center, Washington.
 SO    Kidney Int. 1993 Dec;44(6):1327-40. Unique Identifier : AIDSLINE
       MED/94133542
 AB    Although focal glomerulosclerosis is the most common renal disease,
       other proliferative glomerulonephritides are encountered in HIV-infected
       patients. We studied four HIV-infected patients with renal
       insufficiency, proteinuria, and proliferative glomerulonephritis,
       consistent with immune-mediated disease, to investigate the role of the
       virus and immune complexes in the pathogenesis of the nephropathy.
       Circulating immune complexes (CICs) and HIV-reactive antibodies were
       measured and characterized in each patient. Renal biopsy tissue was acid
       eluted, and the eluate analyzed. DNA extracted from biopsies was
       subjected to the polymerase chain reaction (PCR) to detect HIV genome.
       CICs were detected in each patient: an IgA-p24 HIV antigen complex and
       an IgG antibody-gp 120 HIV antigen complex in two patients; two patients
       had an IgG-p24 HIV antigen complex. Identical complexes were eluted from
       renal tissue in the first three patients; p24 HIV antigen, and
       complement from the fourth. The eluted antibodies reacted with the HIV
       antigens from the isolated CICs. Direct immunofluorescence for viral
       antigen in the eluted glomerular tissue revealed HIV antigens; PCR
       confirmed the presence of gag genome in all four biopsies. We conclude
       both circulating and in-situ HIV antigen-specific immune complexes may
       be associated with glomerulonephritis in HIV infected patients. Viral
       incorporation into renal tissue may be important in the pathogenesis of
       HIV-associated renal disease.
 DE    Adult  Antigen-Antibody Complex/ANALYSIS  AIDS-Associated
       Nephropathy/*IMMUNOLOGY/PATHOLOGY  Biopsy  Case Report  Genome, Viral
       Human  HIV/GENETICS  HIV Antigens/*ANALYSIS  Immunohistochemistry
       Kidney/PATHOLOGY  Male  Middle Age  Polymerase Chain Reaction  Support,
       U.S. Gov't, P.H.S.  JOURNAL ARTICLE

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