HIV and AIDS

The immune system is the body’s defence against infections. HIV, known as the human immunodeficiency virus is a virus that damages the CD4 cells of the immune system, making the defence weak and allow for infections to develop that the body cannot fight off. Over time, HIV infects and destroys the CD4 cells making the body vulnerable to infections and cancers. It is once the immune system is fully compromised to life threatening diseases that it is deemed AIDS, acquired immunodeficiency syndrome. Due to the breakdown of the immune system and functioning of the organs, as well as the toxicity of HIV and AIDS medications, chronic kidney disease and kidney failure are common among those infected.

What are the symptoms?

Depending on the phase and stage of infection, HIV symptoms may look like flu-symptoms after contracting the virus. Although your body is attempting to fight off the virus, the symptoms may be very mild. As the virus multiplies and infects the CD4 cells, you should experience infections and chronic symptoms.

If left untreated, the virus may progress to AIDS in which the immune system is compromised and serious infections may take over. This usually takes a very long time, and luckily through educating and creating awareness, most people are able to receive treatment before their HIV has progressed to AIDS.

What are the complications of HIV and AIDS?

Because HIV and AIDS attack the immune system, complications that are common in those with HIV and AIDS include Tuberculosis, Cryptococcal meningitis, Candidiasis, Cryptosporidiosis, Cytomegalovirus, wasting syndrome, and neurological complications like depression, anxiety and dementia. Furthermore, those with compromised immune systems are at risk of opportunistic cancers like Kaposi's sarcoma, a tumor of the blood vessel walls and Lymphoma. Kidney disease or HIV-associated nephropathy (HIVAN) is also common among those with compromised immune systems due to the virus as inflammation of the filters in the kidney mean that excess fluids and wastes cannot be filtered out of the body.

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How does HIV and AIDS affect the kidneys?

Acute kidney disease and failure occur in HIV infected individuals due to the various opportunistic infections that come with the compromised immune system, in fact, as many as 2% of those with kidney failure are HIV positive.

While HIV and AIDS are both lifelong conditions that have no cure, management and treatment may help reduce the symptoms and allow those with HIV to remain in HIV before progressing to full-blown AIDS. Life expectancy and quality of life of those with HIV have been dramatically improved by Anti-Retroviral Therapy (ART).

Anti-Retroviral Therapy (ART) is now recommended for all HIV diagnosed individuals regardless of the stage of progression status of their infection. While this may slow the progression of HIV into AIDS, these medications also have severe side effects that affect kidney functioning including a build-up of lactic acid and crystals in the body as well as electrolyte abnormalities and interstitial nephritis. Types of kidney diseases that affect those with HIV and AIDS include:

  • Glomerular-dominant nephropathies
  • Tubulointerstitial-dominant nephropathies
  • Vascular-dominant nephropathies
  • Other nephropathies in the setting of HIV infection such as diabetic nephropathy and age-related nephrosclerosis

Symptoms of chronic kidney disease such as facial swelling, changes in urination, fatigue and loss of appetite may only become apparent once kidney functioning has been compromised and may be confused with other symptoms of HIV and AIDS.

Treatment options for HIV-associated nephropathy (HIVAN)

After diagnosing HIV-associated nephropathy using urine, blood urea nitrogen or creatinine clearance tests, treatment for Chronic Kidney Disease and Failure will be tailored by Dr Machailo to suit the needs of each individual patient. Be it changing the class of antiretroviral medications that you are receiving, beginning dialysis to manage kidney disease or considering a kidney transplant, Dr Machailo will be able to assist you in managing your condition and ensuring you live a full life of fulfilment.

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