The histological appearances of the adult kidney in HIV infection at autopsy at the University Teaching Hospital in Lusaka

Abstract

Background: Kidney disease in acquired immunodeficiency syndrome is very common. The cause of the various histological appearances include HIV infection of the kidney, immunologic responses to the virus, opportunistic infections, neoplasms and consequences of anti-retroviral therapy that characterize the acquired immunodeficiency virus (AIDS). There are no autopsy studies conducted in HIV-infected cases in sub-Saharan Africa on the histological lesions of the kidney.

Objective: To describe kidney histological appearances in HIV infection using autopsy material at the UTH, Lusaka.

Methods: A descriptive study of 200 paraffin blocked kidney autopsy tissue samples collected between 2010 and 2012 in the Zambia Neuro-AIDS study (Subtype C Neuro-AIDS and pathogenesis in Zambia) was conducted at the University Teaching hospital in Lusaka, Zambia. The study aimed at describing the histological appearances of the adult kidney in Human Immunodeficiency Virus infection.

The study population consisted of all HIV infected cases above the age of 16years that had been on anti-retroviral therapy and those that were not commenced. The decedents were unselected for the presence of overt kidney disease. Paraffin blocked kidney tissue samples were processed according to standard histopathology laboratory protocols at the University Teaching Hospital and examined at light microscopic level.

Results: Two hundred (200) cases were examined of which 128 cases were male and 72 were female. One hundred and sixty nine cases (84.5%) revealed renal lesions. The renal histopathological lesions included; tubulointerstitial 65%, glomerular 59%, vascular 2%, and 19.5 % of cases revealed renal tuberculosis. Fungal, viral infections and malignancies were not identified.

Conclusion: The investigation has shown that renal lesions are highly prevalent (84.5%) among HIV infected cases at the University Teaching Hospital.