AIDS – Alterações renais em crianças HIV+. Material de necrópsia. Estudo histopatológico e clínico

ABSTRACT

The nephropathy associated with the AIDS virus (N-AIDS) has been described in 30% of the HIV+ children who have the perinatal infection. This contrasts with the low number found in the pediatric population infected with HIV by blood transfusions and breastfeeding. Its pathogenesis is unclear. Recent studies demonstrating the presence of HIV suggest that this virus directly affects the kidney parenchima. HIV-associated nephropathy is clinically characterized by nephrotic proteinuria, occasionally hematuria and by the frequent progression to renal failure. Morphologically, HIV associated nephropathy (N-AIDS) is characterized by focal segmental glomerulosclerosis, diffuse mesangial hyperplasia, tubular microcystic dilation, celular infiltration, interstitial edema and fibrosis. This project aims at the identification of the AIDS nephropathy in pediatric autopsies from 1993 to 1998. Specifically, to describe the clinical and hystopathological findings in the kidneys of children with AIDS who died from the disease; also, to record the most frequent ultra-estructural abnormalities; furthermore, to investigate the presence of viral particles through immunohystochemistry and detect the antigen gp41 in kidney cells. The selection of cases was made after checking patients’ data and those considered HIV+, according to CDC criteria, were studied. Later on, autopsy results were revised. Also, there was a retrospective study of the optic and electronic microscopy. The gp41 protein of the immunodeficiency human virus is part of the gp 41/ gp 120 glicoproteic complex and plays an important role in the viral infection. The HIV investigation in the kidney parenchima will still be made, through detection of the 41-glicoprotein by means of the immunohystochemistry technique using the antibody anti-gp 41. Through this research we intend not only to call attention to kidney damages among HIV+ pediatric population, but also to contribute to the thorough understanding of the pathogenesis of HIV-associated nefropathy, which remains unclear and can be the early symptom of the disease