HIVAN is a common complication among HIV patients, and the US findings may evolve as part of the natural history of the disease. Clinical AIDS is a major negative prognostic indicator, especially when the CD4 count is less than 50 cells/uL. The presence of parenchymal inhomogeneity, decreased visibility of renal sinus fat, and decreased cortiomedullary definition are, correspondingly, associated with poorer outcomes. Prior to HAART, mortality with a diagnosis of HIVAN was 100% within 6 months. With the advent of newer therapies, survival has greatly improved. For most patients, opportunistic infection rather than renal disease will be the cause of death.
Ryan Alexander, MD
PGY1, University of Pittsburgh School of Medicine
Department of Radiology