BRIEF REPORT - IDIOTYPIC IGA NEPHROPATHY IN PATIENTS WITH HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION

SEVERAL renal syndromes have been described in patients with human immunodeficiency virus (HIV) infection. The most common renal abnormality is focal segmental glomerulosclerosis,1 2 3 but some patients have evidence of immune-complex nephropathy,1 2 3 including membranoproliferative and diffuse proliferative glomerulonephritis,4 membranous nephropathy,5 and IgA nephropathy.6 , 7 HIV-related antigen–antibody circulating immune complexes have been demonstrated in patients with HIV infection,8 9 10 11 12 13 but not in renal tissue from patients with both the infection and renal disease; therefore, the importance of the circulating complexes is unknown. Although the pathogenesis of IgA nephropathy in patients with HIV infection6 , 7 is unknown, genetic factors or immune-complex mechanisms may be involved.14 , 15 Idiotypes,… © 1992, Massachusetts Medical Society. All rights reserved.