Microscopy has had a major role in the analysis of renal disorders associated with human immunodeficiency virus (HIV) infection, both as a diagnostic method and as a means of studying pathogenic mechanisms. In the diagnostic realm, microscopic analysis of renal tissue obtained at biopsy and autopsy is a mainstay for the detection of a wide range of glomerular, vascular, and tubulointerstitial diseases. As an investigative tool, microscopy has made an important, albeit somewhat controversial, contribution to our understanding of the pathogenesis of at least one HIV-associated renal lesion.

A variety of ultrastructural alterations have been documented in association with HIV infection. These include tubuloreticular inclusions (most commonly seen in vascular endothelial cells and mononuclear leukocytes)(Fig. la), cylindrical confronting cisternae (typically found in mononuclear leukocytes) (Fig. lb), and nuclear abnormalities such as nuclear bodies and granular change (most often in tubulointerstitial cells) (Fig. lc).