Virchows Archiv

, Volume 450, Issue 6, pp 665–670 | Cite as

Acute interstitial nephritis of HIV-positive patients under atazanavir and tenofovir therapy in a retrospective analysis of kidney biopsies

  • Simone Schmid
  • Milos Opravil
  • Michael Moddel
  • Milo Huber
  • Rahel Pfammatter
  • Gerald Keusch
  • Patrice Ambuhl
  • Rudolf P. Wuthrich
  • Holger Moch
  • Zsuzsanna Varga
Original Article


We performed a retrospective analysis on kidney biopsies of 30 human immunodeficiency virus (HIV)-positive patients. Twenty-two of them received highly active antiretroviral therapy (HAART). Tenofovir containing HAART together with atazanavir, a new protease inhibitor, was administered to three patients. All of them developed acute renal failure. The kidney biopsies of these patients showed an acute interstitial nephritis or a chronic interstitial nephritis with an acute component. Withdrawal of atazanavir and tenofovir resulted in recovery of renal function in all three patients. Acute interstitial nephritis was observed only in 1 of 19 patients without atazanavir or tenofovir treatment. We conclude that acute interstitial nephritis and consecutive acute renal failure is a relevant side effect of atazanavir and tenofovir therapy in HIV-positive patients.


HIV Interstitial nephritis Kidney biopsy Atazanavir 



The technical assistance of Mrs. Juliane Bigott and Mrs. Doris Guntersweiler is highly appreciated. Mr. N. Wey helped in the illustration. The study complies with the current ethical laws of the involved institutions.


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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Simone Schmid
    • 1
  • Milos Opravil
    • 2
  • Michael Moddel
    • 3
  • Milo Huber
    • 2
  • Rahel Pfammatter
    • 3
  • Gerald Keusch
    • 3
  • Patrice Ambuhl
    • 4
  • Rudolf P. Wuthrich
    • 4
  • Holger Moch
    • 1
  • Zsuzsanna Varga
    • 1
  1. 1.Department of Pathology, Institute of Surgical PathologyUniversity Hospital ZurichZurichSwitzerland
  2. 2.Department of Internal Medicine, Division of Infectious DiseasesUniversity Hospital ZurichZurichSwitzerland
  3. 3.Department of NephrologyCity Hospital WaidZurichSwitzerland
  4. 4.Clinic of NephrologyUniversity Hospital ZurichZurichSwitzerland

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