Case of HIV-associated nephropathy accompanied by nephrotic syndrome and acute worsening of kidney function

A previously healthy black man presented with acute kidney injury wtih nephrotic syndrome. His serum creatinine and albumin concentrations were 8.0 mg/dL and 0.4 g/dL, respectively. Renal ultrasound demonstrated an enlarged kidney with an extremely high echogenic cortex. Human immunodeficiency virus (HIV) was serologically positive, and kidney biopsy revealed a collapsing variant of focal segmental glomerulosclerosis with interstitial nephritis. He was diagnosed as having HIV-associated nephropathy (HIVAN). Although there have been only a few cases with characteristic HIVAN features in Japan, the number of patients with HIVAN who need dialysis treatment is relatively high globally, and is expected to increase even in Japan. The rapid clinical course of HIVAN, along with its characteristic histology and the direct pathogenesis of HIV on podocytes, is noteworthy. We described this case with reference to some recent findings.