Diffuse Proliferative Exudative Glomerulonephritis in HIV and Syphilis Coinfection: A Case Report
REVISTA DE NEFROLOGIA DIALISIS Y TRASPLANTE, cilt.46, sa.3, ss.165-170, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 46 Sayı: 3
- Basım Tarihi: 2026
- Dergi Adı: REVISTA DE NEFROLOGIA DIALISIS Y TRASPLANTE
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Fuente Academica Plus, EMBASE, Directory of Open Access Journals, DIALNET, Academic Search Ultimate (EBSCO)
- Sayfa Sayıları: ss.165-170
- Gazi Üniversitesi Adresli: Evet
Özet
Human immunodeficiency virus (HIV) and syphilis can independently cause renal involvement; however, their coexistence rarely results in diffuse proliferative exudative glomerulonephritis (GN). The management of immune complex-mediated GN in HIV-infected patients remains challenging, particularly regarding the role of immunosuppressive therapy. We report a 20-year-old Turkish male with HIV-syphilis co-infection who presented with nephroticrange proteinuria (6.5 g/day) and hypoalbuminemia (2.1 g/dL). Kidney biopsy revealed diffuse endocapillary hypercellularity with neutrophilic infiltration and immune complex deposition of IgG, IgA, C3, and C1q. The patient was treated with benzathine penicillin and antiretroviral therapy, followed by tacrolimus and prednisolone after cytomegalovirus clearance. Under combined antimicrobial, antiretroviral, and carefully monitored immunosuppressive therapy, proteinuria decreased to 1 g/day, serum albumin normalized, and renal function stabilized. HIV RNA became undetectable, and CD4 count increased significantly, suggesting effective viral control without compromising renal recovery. This case underscores the importance of kidney biopsy in HIV-infected patients presenting with nephrotic syndrome. In selected cases, adjunct immunosuppression may be considered a viable therapeutic option when combined with effective infection control and close monitoring.