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Imaging and Histopathologic Features of HIV-related Renal Disease¹

¹ From the Department of Radiology, Royal Free Hospital, Pond Street, London NW3 2QG, England. Presented as an education exhibit at the 2006 RSNA Annual Meeting. Received May 24, 2007; revision requested September 28; final revision received January 23, 2008; accepted February 8. All authors have no financial relationships to disclose. Address correspondence to C.S. (e-mail: symeonidouc{at}yahoo.co.uk).

Despite extraordinary recent advances in the management of human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome, patients infected with HIV are still susceptible to a variety of complications that stem either from immunodeficiency or from side effects of antiretroviral regimens. Diagnosis is often challenging, since every organ in the body can be affected by HIV, and the kidneys have been increasingly shown to be involved by a variety of disease processes. Opportunistic infections including those caused by atypical organisms, malignancies such as lymphoma and Kaposi sarcoma, and disease processes specific to HIV infection such as HIV-associated nephropathy have all been shown to affect the kidneys. In this era of highly active antiretroviral therapy (HAART), renal disease arising secondary to antiretroviral medication has been added to the list. Furthermore, the introduction of HAART has increased survival of HIV-infected patients; consequently, the frequency of HIV-associated and incidental renal disease is expected to rise in this population. Because mortality and morbidity rates are affected by the early recognition of renal disease in HIV-infected patients, it is paramount that the radiologist be familiar with the imaging features that can be encountered in such cases.

© RSNA, 2008