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Renal Epithelium Is a Previously Unrecognized Site of HIV-1 Infection

LESLIE A. BRUGGEMAN^*, MICHAEL D. ROSS^*, NOZOMU TANJI^§, ANDREA CARA, STEVEN DIKMAN, RONALD E. GORDON, GODFREY C. BURNS^||, VIVETTE D. D'AGATI^§, JONATHAN A. WINSTON^*, MARY E. KLOTMAN and PAUL E. KLOTMAN^*

^* Division of Nephrology, Mount Sinai School of Medicine, New York, New York.
Division of Infectious Diseases, Mount Sinai School of Medicine, New York, New York.
Department of Pathology, Mount Sinai School of Medicine, New York, New York.
^§ Department of Pathology, Columbia University College of Physicians and Surgeons, New York, New York.
^|| Department of Medicine, St. Vincent's Hospital and Medical Center, New York, New York.

Correspondence to Dr. Leslie Bruggeman, Box 1243, Division of Nephrology, Mount Sinai School of Medicine, 1 Gustave L. Levy Place, New York, NY 10029. Phone: 212-241-8002; Fax: 212-987-0389; E-mail: lbrugge{at}smtplink.mssm.edu

Abstract. The striking emergence of an epidemic of HIV-related renal disease in patients with end-stage renal disease provided the rationale for the exploration of whether HIV-1 directly infects renal parenchymal cells. Renal glomerular and tubular epithelial cells contain HIV-1 mRNA and DNA, indicating infection by HIV-1. In addition, circularized viral DNA, a marker of recent nuclear import of full-length, reverse-transcribed RNA, was detected in the biopsies, suggesting active replication in renal tissue. Infiltrating infected leukocytes harbored more viral mRNA than renal epithelium. Identification of this novel reservoir suggests that effectively targeting the kidney with antiretrovirals may be critical for patients who are seropositive with renal disease. Thus, renal epithelium constitutes a unique and previously unrecognized cell target for HIV-1 infection.

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