Abstract: TH-PO1104
Spectrum of Kidney Biopsy in People Living with HIV in Japan: Vascular Lesions and Clinical Correlates
Session Information
- Pathology and Lab Medicine
October 22, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Pathology and Lab Medicine
- 1700 Pathology and Lab Medicine
Authors
- Sakamoto, Emi, Nihon Ika Daigaku, Bunkyo, Tokyo, Japan
- Takeuchi, Kazuhiro, Nihon Ika Daigaku, Bunkyo, Tokyo, Japan
- Kuno, Hideaki, Nihon Ika Daigaku, Bunkyo, Tokyo, Japan
- Suzuki, Minami, Kokuritsu Kenko Kiki Kanri Kenkyu Kiko, Shinjuku, Tokyo, Japan
- Katagiri, Daisuke, Kokuritsu Kenko Kiki Kanri Kenkyu Kiko, Shinjuku, Tokyo, Japan
- Takano, Hideki, Kokuritsu Kenko Kiki Kanri Kenkyu Kiko, Shinjuku, Tokyo, Japan
- Shimizu, Akira, Nihon Ika Daigaku, Bunkyo, Tokyo, Japan
Background
Kidney disease in people living with HIV (PLWH) has evolved in the antiretroviral therapy (ART) era, with declining HIV-associated nephropathy (HIVAN) and increasing vascular and comorbidity-related lesions. However, biopsy-based data in Asian populations remain limited. We aimed to characterize the contemporary spectrum of biopsy-proven kidney disease in people living with HIV in Japan and to identify clinical factors associated with arteriolar hyalinosis (AAH).
Methods
We retrospectively analyzed native kidney biopsies from 30 people living with HIV at a single tertiary center in Japan (2010–2024). Histopathological diagnoses were established using standard criteria. AAH was graded using the Banff alternative arteriolar hyalinosis score (0–3). Associations between AAH severity and clinical variables (age, body mass index, serum uric acid, hypertension, diabetes, hyperlipidemia, and smoking) were assessed using univariable and multivariable ordinal logistic regression.
Results
The median age was 49 years, and 90% were male. Most were receiving ART (80%), with a median duration of 12.8 years. The most common diagnoses were arteriosclerotic nephrosclerosis and IgA nephropathy (7 cases each), followed by membranous nephropathy and minor glomerular abnormalities (3 cases each). HIVAN was identified in only one untreated individual.
AAH was frequently observed. Older age, hypertension, and longer ART duration were associated with higher AAH scores in univariable analyses. In multivariable analysis, only longer ART duration remained independently associated with AAH severity (adjusted OR 1.19 per year; 95% CI 1.06–1.37).
Conclusion
In this Japanese biopsy cohort, kidney disease in people living with HIV is predominantly vascular and comorbidity-related, with HIVAN being rare. Longer ART duration is independently associated with arteriolar hyalinosis, suggesting cumulative vascular injury in the ART era.