Idiotypic IgA Nephropathy in Patients with Human Immunodeficiency Virus Infection

SEVERAL renal syndromes have been described in patients with human immunodeficiency virus (HIV) infection. The most common renal abnormality is focal segmental glomerulosclerosis,1 2 3 but some patients have evidence of immune-complex nephropathy,1 2 3 including membranoproliferative and diffuse proliferative glomerulonephritis,4 membranous nephropathy,5 and IgA nephropathy.6 , 7 HIV-related antigen–antibody circulating immune complexes have been demonstrated in patients with HIV infection,8 9 10 11 12 13 but not in renal tissue from patients with both the infection and renal disease; therefore, the importance of the circulating complexes is unknown. Although the pathogenesis of IgA nephropathy in patients with HIV infection6 , 7 is unknown, genetic factors or immune-complex mechanisms may be involved.14 , 15 Idiotypes, . . .