Human Immunodeficiency Virus-associated Immune Complex Kidney Disease Progressing to End-stage Kidney Disease

A 58-year-old man with human immunodeficiency virus (HIV) infection presented with a week-long history of gross hematuria, nephrotic proteinuria, and acute kidney injury. The patient was non-adherent with combination antiretroviral therapy. A kidney biopsy showed cellular crescents with disruption of Bowman’s capsule, C3-dominant immune complex deposition, consistent with HIV-associated immune complex kidney disease (HIVICK). During the course, his worsening kidney function warranted initiation of hemodialysis. This case highlights the fact that HIV patients are at an increased risk of developing HIVICK, especially in the setting of non-adherence. A greater understanding of HIVICK among HIV patients should promote additional investigation into its etiology and viable treatments.