infecţio
ro
necesară dializa renală sau chiar trans- Concluzii aplicate, tot mai diferenţiat, pacienţilor
plantul renal. Trebuie avut în vedere şi Deşi în aparenţă terapia afecţiunilor infectaţi cu HIV. Investigarea cât mai
comunicat acestor pacienţi că respec- renale nu mai este o necunoscută, există precoce a pacienţilor cu HIV, în scopul
tivele manevre nu sunt deloc lipsite unele particularităţi ale bolnavilor depistării unor modificări renale, poate
de risc şi că starea de imunodepresie infectaţi cu HIV care dezvoltă afectări fi o măsură profilactică eficace. So-
se va accentua după efectuarea trans- renale, generate fie de efectul însuşi al cietatea de Boli Infecţioase din Ame-
plantului renal. HIV asupra sistemului imun şi al struc- rica recomandă în mod curent ca toţi
Cele mai multe centre acceptă pen- turilor funcţionale renale, fie de terapia subiecţii infectaţi HIV să fie incluşi în
tru transplant doar pacienţii cu HIV cu ARV, din care, aşa cum am văzut, In- screening-uri pentru depistarea unor
al căror număr de celule CD4 este dinavirul şi Tenofovirul se evidenţiază afecţiuni renale, iar cei dintre ei cu ne-
>200/mm
3
, iar încărcătura virală - prin grade diferite de nefrotoxicitate sau fropatii preexistente să fie evaluaţi cel
nedetectabilă. Restul problemelor inducere de litiază renală. puţin lunar
(2)
. Ni se pare sugestivă formu-
generate de transplant sunt aceleaşi De aceea, sub ochii noştri se dezvoltă larea pacienţilor americani infectaţi cu
ca şi în cazul pacienţilor neinfectaţi noi protocoale de investigaţie şi tera- HIV, în momentul prezentării la medic:
cu HIV. peutice nefrologice care sunt şi vor fi „Ei, doctore, rinichii mei sunt OK?”. n
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