Table 1 Cases of ANCA Positivity in HIV-Infected Individuals Reported in the Literature
From: ANCA-associated vasculitis in a HIV-infected patient:a case-based review
Study | Type of study | Number of patients | Immunovirological status | ANCA positivity | Clinical manifestations | Correlation with the stage of the disease | Treatment |
|---|---|---|---|---|---|---|---|
Evans [8] | Case report | 1 | CD4 > 400 cells/mm3 UndetectableVL (under Ritonavir and Darunavir) | pANCA > 100 IU/ml | Renal (Acute kidney injury, nephritic syndrome), articular, ophthalmological | No | Glucocorticosteroids, rituximab |
Romano [25] | Case report | 1 | CD4 27 cells/mm3 VL-NR Untreated before | cANCA 251–736 UA/ml | No clinical vasculitis | At diagnosis | - |
Mirsaedi [9] | Case report | 1 | CD4 146 cells/mm3 VL- 91,469 c/ml Untreated before | pANCA 68 U/ml | Renal (Acute kidney injury, nephritic syndrome), pulmonary | At diagnosis | Glucocorticosteroids, cyclophosphamide, HAART |
Mohapatra [15] | Case report | 1 | CD4 0.9/µl Viral load- NR Untreated before | cANCA- titer NR | Pulmonary | At diagnosis | Glucocorticosteroids, Cyclophosphamide, HAART |
Jansen [10] | Case report | 1 | CD4 18 × 106/l Untreated before | cANCA 1/320 | No clinical vasculitis | At diagnosis | HAART |
Davenport [14] | Case report | 1 patient | CDC grade 4 disease -at diagnosis | Perinuclear with some focal intracytoplasmic positivity (IF) | Renal (intermittent hematuria and proteinuria) and neurologic (peripheral neuropathy) | - | Corticosteroids |
Reville [23] | Review (1 case report) | 1 patient | NR | cANCA positivity titer NR | Severe sinusitis and pulmonary involvement (infiltrates) | NR | Corticosteroids |
Klassen [16] | Case report Cross-sectional | -82 pt. +: -1 index pt. presented separately -1 pt. presented separately | VL-not reported Treatment- NR − 21 asymptomatic HIV+ (CD4 > = 0.5 × 109/l -26 asymptomatic HIV+(CD4 < 0.5 × 109/l -26) -10 pt. with ARC (CDC group IV A) -14 pt. with AIDS-OI -11 pt. with AIDS- MAL | -5 ANCA+/10 ARC -2 ANCA+/14 AIDS-OI -4 ANCA+/11-AIDS-MAL -No ANCA positivity in asymptomatic HIV; pANCA-3 pt. cANCA- 8 pt | Index patient-articular, cutaneous 1 Dutch pt.- renal involvement 48 pt. -No clinical vasculitis | Correlation with disease stage- “The occurrence of ANCA was limited to the symptomatic stages of HIV infection with the exception of the index pt.” | Corticosteroids |
Cornelly [11] | Observational Prospective | 199 | Median CD4 80/ul VL-NR 77%-AIDS 76% on ART | 20% ANCA + (IF) Atypical ANCA 67%, pANCA 33% | No clinical vasculitis | No correlation with the stage of the disease. | - |
Sorrentino [24] | Observational | 88 | VL, CD4-NR Treatment-NR (49-asymptomatic HIV; 39- symptomatic HIV) | ANCA positivity: 21/39 (53.8%)-symptomatic HIV 2/49 (4.1%)- asymptomatic HIV | No clinical vasculitis | Correlation with disease stage | - |
Iordache [5] | Cross-sectional | 92 pt. | HAART 85% Median mean CD4 611/mm3 VL undetectable in 74% of pt. | At least 1 Ab (45%) ANCA-13% | 12% from the whole cohort had > = 1 clinically relevant Ab | Ab presence is associated with CD4 count. | - |
Savige [12] | Observational | 105 pt. | 55 pt. were treated with Zidovudine and 34 were not. CD4 counts < 400/ul in 78 pt.; >400/ul in 11 pt. Asymptomatic infection- 37 pt. ARC − 32 pt. AIDS-36 pt. | ANCA+-18 pt. cANCA-4 pANCA-4 atypical-10 | No clinical vasculitis | There was no significant correlation between ANCA positivity and immunological status. | - |
Koderisch [6] | Observational | 29 patients (45 sera) | VL-NR Median T4/T8 ratio 0.43 3-asymptomatic 16- lymphadenopathy syndrome 5- ARC 5-AIDS (2-KAPOSI) | 31 sera/24 patients- faint homogenous cytoplasmatic staining of neutrophils (IF) 4 sera/3 patients-faint cANCA 0-pANCA; 9sera/5 pt.-borderline + ANCA-ELISA 3 pt- mpo-ELISA + | No clinical vasculitis | No correlation between ANCA and stage of disease. | - |
Iordache [7] | Retrospective descriptive | 52 patients -> 1 case of granulomatosis with polyangiitis | Good immunovirological status | Transiently cANCA + | GPA confirmed histological | - | Immunosuppressant treatment (the drugs NR) |