Multiple facets of HIV-associated renal disease

HIV infection has a broad spectrum of renal manifestations. This study examined the clinical and histological manifestations of HIV-associated renal disease, and predictors of renal outcomes. Sixty-one (64% male, mean age 45 years) HIV patients were retrospectively evaluated. Clinical presentation and renal histopathology were assessed, as well as CD4 T-cell count and viral load. The predictive value of histological lesion, baseline CD4 cell count and viral load for end-stage renal disease (ESRD) or death were determined using the Cox regression model. The outcomes of chronic kidney disease (CKD) and ESRD or death were evaluated by baseline CD4 cell count. The percent distribution at initial clinical presentation was non-nephrotic proteinuria (54%), acute kidney injury (28%), nephrotic syndrome (23%), and chronic kidney disease (22%). Focal segmental glomerulosclerosis (28%), mainly the collapsing form (HIVAN), acute interstitial nephritis (AIN) (26%), and immune complex-mediated glomerulonephritis (ICGN) (25%) were the predominant renal histology. Baseline CD4 cell count ≥200 cells/mm3 was a protective factor against CKD (hazard ratio=0.997; 95%CI=0.994-0.999; P=0.012). At last follow-up, 64% of patients with baseline CD4 ≥200 cells/mm3 had eGFR >60 mL·min-1·(1.73 m2)-1 compared to the other 35% of patients who presented with CD4 <200 cells/mm3 (log rank=9.043, P=0.003). In conclusion, the main histological lesion of HIV-associated renal disease was HIVAN, followed by AIN and ICGN. These findings reinforce the need to biopsy HIV patients with kidney impairment and/or proteinuria. Baseline CD4 cell count ≥200 cells/mm3 was associated with better renal function after 2 years of follow-up.

Evaluation of the BAX® system for the detection of Salmonella spp. in naturally contaminated chicken meat

The aim of this study was to verify the efficiency of the BAX® system for the detection of Salmonella spp. in raw chicken meat. The conventional culture method (IN 62, MAP) was used as a reference method. A total of 8,813 chicken carcass samples were analyzed. In the first part of the study, 1,200 samples were analyzed using the BAX® System and the conventional culture method. In the second part, 7,613 samples were analyzed by the BAX® system, and the conventional method was used only for samples that tested positive for Salmonella spp. by the BAX® system. The sensitivity, specificity, relative accuracy, positive predictive value, and negative predictive value obtained in the first part of this study were 100%, 92.3%, 96.4%, 53.3% and 100%, respectively. The BAX® system showed no false-negative results and reduced the time to obtain presumptive positive results. It is a suitable method for use in laboratories that perform a large number of food samples analyses daily. However, the conventional method is still required to confirm the presence of Salmonella spp. in samples that test positive using the BAX® system.