Background: Human immunodeficiency virus (HIV) type 2 infection is predominantly
found in West African nations, and approximately 1-2 million
people are thought to be infected. HIV-associated nephropathy (HIVAN) occurs in
about 7% of patients with HIV-1 infection and is one of the most important causes
of end-stage renal disease in this population. The only reported case of HIVAN related
to HIV-2 infection was described by Izzedine et al. (2006). Aim: The aim of this paper is to report a case of HIVAN
in an HIV-2-infected patient, a rarely described condition. Case presentation: We
describe a case of a 40-year-old HIV-2-infected female from Angola hospitalized
following a six-month history of fever, fatigue, anorexia and weight loss. Laboratory
data revealed anaemia, leukopenia and renal dysfunction with nephrotic range proteinuria.
Renal biopsy was performed, revealing findings consistent with HIVAN. Also, a presumed
diagnosis of ganglionic tuberculosis was established. Conclusion: The slow progression
of HIV-2 disease could explain the low frequency of this condition, however, more
studies should be carried out for a better understanding of HIV-2 pathophysiology
and its associated complications.
References
[1]
World Health Organisation (2019) HIV/AIDS. http://who.int/hiv/en
[2]
Gottlieb, G.S., Eholie, S.P., Nkengasong, J.N., Jallow, S., Rowland-Jones, S., Whitlle, H.C., et al. (2008) A Call for Randomized Controlled Trials of Antiretroviral Therapy for HIV-2 Infection in West Africa. AIDS, 22, 2069-2074.
https://doi.org/10.1097/QAD.0b013e32830edd44
[3]
Clavel, F., Guetard, D., Brun-Vezinet, F., Chamaret, S., Rey, M.A., Santos-Ferreira, et al. (1986) Isolation of a New Human Retrovirus from West African Patients with AIDS. Science, 233, 343-346. https://doi.org/10.1126/science.2425430
[4]
de Silva, T.I., Cotten, M. and Rowland-Jones, S.L. (2008) HIV-2: The Forgotten AIDS Virus. Trends in Microbiology, 16, 588-595.
https://doi.org/10.1016/j.tim.2008.09.003
[5]
Portugal. Ministério da Saúde. Direçâo-Geral da Saúde/Instituto Nacional de Saúde Doutor Ricardo Jorge (2019) Infeçâo VIH e SIDA em Portugal. DGS/INSA, Lisboa.
http://www.insa.min-saude.pt/relatorio-infecao-vih-e-sida-em-portugal-2019
[6]
Popper, S.J., Sarr, A.D., Travers, K.U., Guèye-Ndiaye, A., Mboup, S., Essex, M.E., et al. (1999) Lower Human Immunodeficiency Virus (HIV) Type 2 Viral Load Reflects the Difference in Pathogenicity of HIV-1 and HIV-2. The Journal of Infectious Diseases, 180, 1116-1121. https://doi.org/10.1086/315010
[7]
MacNeil, A., Sarr, A.D., Sankale, J.L., Meloni, S.T., Mboup, S. and Kanki, P. (2007) Direct Evidence of Lower Viral Replication Rates in Vivo in Human Immunodeficiency Virus Type 2 (HIV-2) Infection than in HIV-1 Infection. Journal of Virology, 81, 5325-5330. https://doi.org/10.1128/JVI.02625-06
[8]
Campbell-Yesufu, O.T. and Gandhi, R.T. (2011) Update on Human Immunodeficiency Virus (HIV)-2 Infection. Clinical Infectious Diseases, 52, 780-787.
https://doi.org/10.1093/cid/ciq248
[9]
Matheron, S., Pueyo, S., Damond, F., Simon, F., Leprêtre, A., Campa, P., et al. (2003) Factors Associated with Clinical Progression in HIV-2 Infected Patients. AIDS, 17, 2593-2601. https://doi.org/10.1097/00002030-200312050-00006
[10]
Esbjõrnsson, J., Mansson, F., Kvist, A., da Silva, Z.J., Andersson, S., Fenyö, E.M., et al. (2018) Long-Term Follow-Up of HIV-2-Related AIDS and Mortality in Guinea-Bissau: A Prospective Open Cohort Study. The Lancet HIV.
https://doi.org/10.1016/S2352-3018(18)30254-6
[11]
Shahinian, V., Rajaraman, S., Borucki, M., Grady, J., Hollander, W.M. and Ahuja, T.S. (2000) Prevalence of HIV-Associated Nephropathy in Autopsies of HIV Infected Patients. American Journal of Kidney Diseases, 35, 884-888.
https://doi.org/10.1016/S0272-6386(00)70259-9
[12]
Izzedine, H., Damond, F., Brocheriou, I., Ghosn, J., Lassal, H. and Deray, G. (2006) HIV-2 Infection and HIV-Associated Nephropathy. AIDS, 20, 949-950.
https://doi.org/10.1097/01.aids.0000218566.05274.2b
[13]
Petri, M., Orbai, A.M., Alarcon, G.S., Gordon, C., Merrill, J.T., Fortin, P.R., et al. (2012) Derivation and Validation of the Systemic Lupus International Collaborating Clinics Classification Criteria for Systemic Lupus Erythematosus. Arthritis & Rheumatology, 64, 2677-2686. https://doi.org/10.1002/art.34473
[14]
Pardo, V., Aldana, M., Colton, R.M., Fischl, M.A., Jaffe, D., Moskowitz, L., et al. (1984) Glomerular Lesions in the Acquired Immunodeficiency Syndrome. Annals of Internal Medicine, 101, 429-434. https://doi.org/10.7326/0003-4819-101-4-429
[15]
Rao, T.K., Filippone, E.J., Nicastri, A.D., Landesman, S.H., Frank, E., Chen, C.K., et al. (1984) Associated Focal and Segmental Glomerulosclerosis in the Acquired Immunodeficiency Syndrome. The New England Journal of Medicine, 310, 669.
https://doi.org/10.1056/NEJM198403153101101
[16]
Wiston, J.A., Bruggeman, L.A., Ross, M.D., Jacobson, J., Ross, L., D’Agati, V.D., et al. (2001) Nephropathy and Establishment of a Renal Reservoir of HIV Type 1 during Primary Infection. The New England Journal of Medicine, 344, 1979.
https://doi.org/10.1056/NEJM200106283442604
[17]
Levin, M.L., Palella, F., Shah, S., Lerma, E., Butter, J. and Kanwar, Y.S. (2001) HIV-Associated Nephropathy Occurring before HIV Antibody Seroconversion. American Journal of Kidney Diseases, 37, e39.
https://doi.org/10.1016/S0272-6386(05)90003-6
[18]
Mocroft, A., Reiss, P., Gasiorowski, J., Ledergerber, B., Kowalska, J., Chiesi, A., et al. (2010) Serious Fatal and Nonfatal Non-AIDS-Defining Illnesses in Europe. Journal of Acquired Immune Deficiency Syndromes, 55, 262-270.
https://doi.org/10.1097/QAI.0b013e3181e9be6b
[19]
Waheed, S. and Atta, M.G. (2014) Predictors of HIV-Associated Nephropathy. Expert Review of Anti-Infective Therapy, 12, 555-563.
https://doi.org/10.1586/14787210.2014.901170
[20]
Swanepoel, C.R., Atta, M.G., D’Agati, V.D., Estrella, M.M., Fogo, A.B., Naicker, S., et al. (2018) Kidney Disease in the Setting of HIV Infection: Conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference. Kidney International, 93, 545-559. https://doi.org/10.1016/j.kint.2017.11.007
[21]
Palau, L., Menez, S., Rodriguez-Sanchez, J., Novick, T., Delsante, M., McMahon, B.A., et al. (2018) HIV-Associated Nephropathy: Links, Risks and Management. HIV Aids (Auckl), 10, 73-81. https://doi.org/10.2147/HIV.S141978
[22]
Fogo, A.B., Lusco, M.A., Najafian, B. and Alpers, C.E. (2016) AJKD Atlas of Renal Pathology: HIV-Associated Nephropathy (HIVAN). American Journal of Kidney Diseases, 68, e13-e14. https://doi.org/10.1053/j.ajkd.2016.06.002
[23]
Ferreira, A.C., Carvalho, D., Carvalho, F., Galvão, M.J. and Nolasco, F. (2011) Renal Pathology in Portuguese HIV-Infected Patients. Portuguese Journal of Nephrology and Hypertension, 25, 275-283.
[24]
Lucas, G.M., Eustace, J.A., Sozio, S., Mentari, E.K., Appiah, K.A. and Moore, R.D. (2004) Highly Active Antiretroviral Therapy and the Incidence of HIV-1-Associated Nephropathy. AIDS, 18, 541-546.
https://doi.org/10.1097/00002030-200402200-00022
[25]
Ntemgwa, M.L., d’Aquin Toni, T., Brenner, B.G., Camacho, R.J. and Wainberg, M.A. (2009) Antiretroviral Drug Resistance in Human Immunodeficiency Virus Type 2. Antimicrobial Agents and Chemotherapy, 53, 3611-3619.
https://doi.org/10.1128/AAC.00154-09
[26]
Witvrouw, M., Pannecouque, C., Switzer, W.M., Folks, T.M., De Clercq, E. and Heneine, W. (2004) Susceptibility of HIV-2, SIV and SHIV to Various Anti-HIV-1 Compounds: Implications for Treatment and Postexposure Prophylaxis. Antiviral Therapy, 9, 57-65.
