HIV Associated Nephropathy (HIVAN) or a collapsing form of focal segmental glomerulosclerosis was the first kidney disease described in HIV patients at the dawn of the HIV epidemic in the 1980s. Over the last three decades, advances in our understanding of the biology of the HIV virus and therapeutic options have resulted in a significant modification in the spectrum of kidney diseases we see in the HIV population. HIV immune complex disease of the kidney (HIVICK) is now a recognized disease entity that presents a differing epidemiology, clinical presentation, pathophysiology, histology and treatment options from the classical HIVAN. In addition, the wide armamentarium of available antiretroviral therapeutic drugs has resulted in various insults to the kidneys, ranging from mitochondrial toxicities to the Fanconi’s Syndrome. Consequently, with effective therapy against the HIV virus, the survival of the HIV population has trended towards that of the general population, and the incidence of renal diseases and causes of ESRD are no longer significantly different in the HIV patient.
