Events - Grand Rounds in Pediatric Nephrology – an ISN-IPNA Sister Centers initiative: HIVAN: Preventable and Treatable, Yet Can Be fatal

HIV associated nephropathy (HIVAN) was first recognized in 1984 and became a frequent cause of ERF in patients, particularly within the Black ethnic community.  With the use of ART and subsequently HART from the 1990’s onward ERF from HIVAN has become much less common in the US and Europe.  In children, who most often have vertically acquired disease, it is no longer seen, despite the evidence of nephrotoxicity from HART itself. 

This is not the case in Africa, despite the free availability of HART and the free provision of services for diagnosis and assessment.  We present a case of ERF in a teenage male patient which led to the patient’s death.  This case is typical of many seen each year.  Most acquire HIV through vertical transmission.  Many of the children are orphans at the time of presentation.  Shame and stigma lead to late diagnosis.  Failure to explain the disease to young people leads to non compliance to therapy.  Relative poverty means RRT is not affordable.  A new approach to HIV in society in Africa is needed.  

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