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A lupus-like glomerulonephritis following acute HIV-1 seroconversion in an African woman.

Human immunodeficiency virus (HIV)-associated nephropathy (HIVAN) is a distinct clinico-pathological entity that is characterized by a proteinuria in the nephrotic range and, in the absence of antiretroviral therapy, rapid progression to end-stage renal disease. HIVAN comprises only HIV-associated glomerulopathies and does not include the tubular disorders or Fanconi syndrome observed in HIV patients [1]. Its most common renal manifestation is the collapsing variant of focal segmental glomerular sclerosis. HIVAN has a racial predilection, affecting blacks more than whites. Micropathological studies have expanded the spectrum of glomerular lesions in HIV-infected patients to include immune complex-mediated glomerulonephritides: immunoglobulin A nephropathy, membranoproliferative glomerulonephritis (MPGN) and lupus-like immune complex glomerulonephritis. All three of these pathological variants, however, are much less common in blacks. To our knowledge, a lupus-like immune complex glomerulonephritis has not been described during acute HIV seroconversion; furthermore, its optimal treatment in such a setting has not been entirely codified. We report a case of lupus-like immune complex glomerulonephritis in a black woman with acute HIV seroconversion who was treated with antiretroviral therapy alone. Case