HIV-associated nephropathy (HIVAN) is almost exclusively seen in African-Americans (AA) and is rare in Caucasians. The mechanisms responsible for the predilection of HIVAN in AA are not well understood. In transgenic mouse studies, genetic background plays a vital role in the development of the HIVAN phenotype. Larger studies in humans have been initiated to study genetic polymorphisms responsible for HIVAN. As our case illustrates, HIVAN should be considered in Caucasian patients with HIV infection complicated by nephrotic syndrome and renal failure.
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