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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">aids</journal-id><journal-title-group><journal-title xml:lang="ru">ВИЧ-инфекция и иммуносупрессии</journal-title><trans-title-group xml:lang="en"><trans-title>HIV Infection and Immunosuppressive Disorders</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2077-9828</issn><publisher><publisher-name>Baltic Medical Education Center</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.22328/2077-9828-2022-14-1-25-36</article-id><article-id custom-type="elpub" pub-id-type="custom">aids-696</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>АНАЛИТИЧЕСКИЙ ОБЗОР</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ANALYTICAL REVIEW</subject></subj-group></article-categories><title-group><article-title>Поражение почек при ВИЧ-инфекции: патогенетические аспекты, клинико-морфологические варианты и роль антиретровирусной терапии</article-title><trans-title-group xml:lang="en"><trans-title>Kidney damage in HIV infection: pathogenetic aspects, clinical and morphological variants and the role of antiretroviral therapy</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8513-9279</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Муркамилов</surname><given-names>И. Т.</given-names></name><name name-style="western" xml:lang="en"><surname>Murkamilov</surname><given-names>I. T.</given-names></name></name-alternatives><bio xml:lang="ru"><p>к.м.н., и. о. доцента кафедры факультетской терапии;</p><p>старший преподаватель,</p><p>нефролог, председатель правления Общества специалистов по  хронической болезни почек Кыргызстана,</p><p>720020, г. Бишкек, ул. Ахунбаева, д. 92</p></bio><bio xml:lang="en"><p>Bishkek</p></bio><email xlink:type="simple">murkamilov.i@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4973-039X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Айтбаев</surname><given-names>К. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Aitbaev</surname><given-names>K. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>д.м.н., профессор, зав. лаборатории патологической физиологии,</p><p>член правления общества специалистов по  хронической болезни почек Кыргызстана,</p><p>720040, г. Бишкек, ул. Т. Молдо, д. 3</p></bio><bio xml:lang="en"><p>Bishkek</p></bio><email xlink:type="simple">kaitbaev@yahoo.com</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2682-4417</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Фомин</surname><given-names>В. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Fomin</surname><given-names>V. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>д.м.н., профессор, член-коресспондент Российской академии наук, заведующий кафедрой факультетской терапии № 1 Института клинической медицины имени Н. В. Склифосовского, проректор по клинической работе и дополнительному профессиональному образованию, </p><p>119991, Москва, ул. Большая Пироговская, д. 2</p></bio><bio xml:lang="en"><p>Moscow</p></bio><email xlink:type="simple">fomin_vic@mail.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7653-0433</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Муркамилова</surname><given-names>Ж. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Murkamilova</surname><given-names>G. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>заочный аспирант,</p><p>720040, г. Бишкек, ул. Т. Молдо, д. 3</p></bio><bio xml:lang="en"><p>Bishkek</p></bio><email xlink:type="simple">murkamilovazh.t@mail.ru</email><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0632-6653</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Юсупов</surname><given-names>Ф. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Yusupov</surname><given-names>F. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>профессор, заведующий кафедрой неврологии, психиатрии и медицинской генетики медицинского факультета,</p><p>член правления общества специалистов по  хронической болезни почек Кыргызстана,</p><p>главный невролог Южного региона Кыргызстана,</p><p>714000, г. Ош, ул. Ленина, д. 331</p></bio><bio xml:lang="en"><p>Osh</p></bio><email xlink:type="simple">furcat_y@mail.ru</email><xref ref-type="aff" rid="aff-5"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0779-0776</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Счастливенко</surname><given-names>А. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Schastlivenko</surname><given-names>A. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>к.м.н., доцент кафедры врача общей практики с  курсом поликлинической терапии,</p><p>г. Витебск</p></bio><bio xml:lang="en"><p>Vitebsk</p></bio><email xlink:type="simple">andrei.schastlivenko@mail.ru</email><xref ref-type="aff" rid="aff-6"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Кыргызская государственная медицинская академия имени И. К. Ахунбаева;&#13;
Кыргызско-Российский Славянский университет</institution><country>Кыргызстан</country></aff><aff xml:lang="en"><institution>Akhunbaev Kyrgyz State Medical Academy;&#13;
Kyrgyz-Russian Slavic University</institution><country>Kyrgyzstan</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Научно-исследовательский институт молекулярной биологии и медицины</institution><country>Кыргызстан</country></aff><aff xml:lang="en"><institution>Scientific Research Institute of Molecular Biology and Medicine</institution><country>Kyrgyzstan</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>Первый Московский государственный медицинский университет имени И. М. Сеченова</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Sechenov First Moscow State Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru"><institution>Кыргызско-Российский Славянский университет</institution><country>Кыргызстан</country></aff><aff xml:lang="en"><institution>Kyrgyz-Russian Slavic University</institution><country>Kyrgyzstan</country></aff></aff-alternatives><aff-alternatives id="aff-5"><aff xml:lang="ru"><institution>Ошский государственный университет</institution><country>Кыргызстан</country></aff><aff xml:lang="en"><institution>Osh State University</institution><country>Kyrgyzstan</country></aff></aff-alternatives><aff-alternatives id="aff-6"><aff xml:lang="ru"><institution>Витебский государственный ордена Дружбы народов медицинский университет</institution><country>Беларусь</country></aff><aff xml:lang="en"><institution>Vitebsk State Order of Peoples Friendship Medical University</institution><country>Belarus</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2022</year></pub-date><pub-date pub-type="epub"><day>17</day><month>05</month><year>2022</year></pub-date><volume>14</volume><issue>1</issue><fpage>25</fpage><lpage>36</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Муркамилов И.Т., Айтбаев К.А., Фомин В.В., Муркамилова Ж.А., Юсупов Ф.А., Счастливенко А.И., 2022</copyright-statement><copyright-year>2022</copyright-year><copyright-holder xml:lang="ru">Муркамилов И.Т., Айтбаев К.А., Фомин В.В., Муркамилова Ж.А., Юсупов Ф.А., Счастливенко А.И.</copyright-holder><copyright-holder xml:lang="en">Murkamilov I.T., Aitbaev K.A., Fomin V.V., Murkamilova G.A., Yusupov F.A., Schastlivenko A.I.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://hiv.bmoc-spb.ru/jour/article/view/696">https://hiv.bmoc-spb.ru/jour/article/view/696</self-uri><abstract><p>В обзоре анализируются распространенность и патогенетические аспекты ВИЧ-инфекции. Изложены основные клиникоморфологические варианты поражения почек при ВИЧ-инфекции. Распространенность поражения почек при ВИЧ-инфекции составляет 20–30%, которые представлены такими клинико-морфологическими вариантами как ВИЧ-ассоциированная нефропатия (ВАН), иммунокомплексная ВИЧ-ассоциированная болезнь почек, а также тромботическая микроангиопатия. У лиц с ВИЧ-инфекцией, не находящихся на антиретровирусной терапии (АРТ), наиболее распространенным типом почечных заболеваний является ВАН. Снижение количества CD4+ клеток, высокая вирусная нагрузка, пожилой возраст и наличие патологии почек у ближайших родственников являются факторами риска развития ВАН. Специфическими факторами риска поражения почек при ВИЧ-инфекции считаются прием антиретровирусных препаратов (тенофовир), бесконтрольное применение которого сопровождается канальцевой дисфункцией. При ВИЧ-инфекции степень иммунодефицита коррелирует с тяжестью поражения почек. Наиболее частыми гистопатологическими проявлениями поражения почек у лиц с ВИЧ-инфекцией являются фокально-сегментарный гломерулосклероз, мембранопролиферативный гломерулонефрит, иммуноглобулин А-нефропатия и мезангиопролиферативный гломерулонефрит. Артериальная гипертензия, нефротический синдром и сниженное число CD4+ клеток служат предвестниками почечной недостаточности при ВИЧ-инфекции. У лиц с ВИЧ-инфекцией, находящихся на АРТ, появление гипокалиемии, ноктурии, полиурии, микрогематурии и/или субнефротической протеинурии свидетельствуют о тубулоинтерстициальном поражении. Для оценки суммарной фильтрационной функции почек у лиц с ВИЧ-инфекцией наиболее приемлемой является формула CKD-EPI. </p></abstract><trans-abstract xml:lang="en"><p>The review analyzes the prevalence and pathogenetic aspects of HIV infection. The main clinical and morphological variants of kidney damage in HIV infection are outlined. The prevalence of kidney damage in HIV infection is 20–30%, which are represented by such clinical and morphological variants as HIV-associated nephropathy (VAN), immunocomplex HIV-associated kidney disease, and thrombotic microangiopathy. In patients with HIV infection who are not treated with antiretroviral therapy (ART) the most common type of kidney disease is HIVAT. A decrease in the number of CD4+ cells, high viral load, advanced age, and the presence of kidney pathology in the next of kin are risk factors for the development of HIVAT. Specific risk factors for kidney damage in HIV infection are the use of antiretroviral drugs (tenofovir), the uncontrolled use of which is accompanied by tubular dysfunction. In HIV infection, the degree of immunodeficiency correlates with the severity of kidney damage. The most common histopathological manifestations of kidney damage in individuals with HIV infection are focal segmental glomerulosclerosis, membranoproliferative glomerulonephritis, immunoglobulin A nephropathy, and mesangioproliferative glomerulonephritis. Hypertension, nephrotic syndrome, and reduced CD4+ cells are predictive of renal failure in HIV infection. In patients with HIV infection who are treated with ART the appearance of hypokalemia, nocturia, polyuria, microhematuria, and/or subnephrotic proteinuria is indicative of tubulointerstitial disease. To assess the total filtration function of the kidneys in people with HIV infection, the most acceptable formula is CKD-EPI. </p></trans-abstract><kwd-group xml:lang="ru"><kwd>ВИЧ</kwd><kwd>вирионы</kwd><kwd>CD4-лимфоциты</kwd><kwd>иммунная система</kwd><kwd>ВИЧ-инфекция</kwd><kwd>распространенность</kwd><kwd>антиретровирусная терапия</kwd><kwd>поражение почек</kwd><kwd>ВИЧ-ассоциированная нефропатия</kwd><kwd>тромботическая микроангиопатия</kwd></kwd-group><kwd-group xml:lang="en"><kwd>HIV</kwd><kwd>virions</kwd><kwd>CD4-lymphocytes</kwd><kwd>immune system</kwd><kwd>HIV infection</kwd><kwd>prevalence</kwd><kwd>antiretroviral therapy</kwd><kwd>kidney damage</kwd><kwd>HIV-associated nephropathy</kwd><kwd>thrombotic microangiopathy</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Тибекина Л.М., Малько В.А., Флуд В.В., Лепилина А.В. 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