A Case of aHUS-Associated Renal Failure Mistakenly Attributed to HIV Nephropathy
Bibliographic record
Abstract
Human immunodeficiency virus infection has been implicated in multiple viral-based processes adversely affecting the renal system, including HIV-associated nephropathy (HIVAN), HIV-related immune complex disease, and the less well-described HIV-related thrombotic microangiopathy (TMA). While HIV nephropathy has an overall poor renal prognosis and is treated primarily with anti-viral therapy, the etiology of HIV-related (non-thrombotic thrombocytopenic purpura-associated) renal TMA may be causally linked to viral amplification of a dysregulated alternate complement cascade. Thus, if detected in its incipient stages, the associated renal injury may respond similarly to complement-inhibitory modalities as has been observed in cases of non-virally-linked TMA (aHUS), thus yielding significant recovery of kidney function. We report a case of a 43-year-old male patient with a history of advanced HIV disease and chronic renal insufficiency, previously attributed to HIVAN, who presented with acute renal decline, microangiopathic hemolytic anemia and thrombocytopenia, and biopsy-proven renal TMA, whose acute renal decompensation responded favorably to terminal complement blockade (eculizumab). J Hematol. 2015;4(1):141-143 doi: http://dx.doi.org/10.14740/jh183w
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.004 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.004 | 0.002 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.006 | 0.005 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".