The HIV epidemic has devastated millions of people globally, with approximately 40 million deaths since its start. The availability of antiretroviral therapy (ART) has transformed the prognosis of millions of individuals infected with HIV such that a diagnosis of HIV infection no longer automatically confers death. However, morbidity and mortality remain substantial among people living with HIV. HIV can directly infect the kidney to cause HIV-associated nephropathy (HIVAN) — a disease characterized by podocyte and tubular damage and associated with an increased risk of kidney failure. The reports of HIVAN occurring primarily in those of African ancestry led to the discovery of its association with APOL1 risk alleles. The advent of ART has led to a substantial decrease in the prevalence of HIVAN; however, reports have emerged of an increase in the prevalence of other kidney pathology, such as focal segmental glomerulosclerosis and pathological conditions associated with co-morbidities of ageing, such as hypertension and diabetes mellitus. Early initiation of ART also results in a longer cumulative exposure to medications, increasing the likelihood of nephrotoxicity. A substantial body of literature supports the use of kidney transplantation in people living with HIV, demonstrating significant survival benefits compared with that of people undergoing chronic dialysis, and similar long-term allograft and patient survival compared with that of HIV-negative kidney transplant recipients.

艾滋病毒疫情自爆发以来已给全球数百万人带来了沉重打击，约有 4000 万人死亡。抗逆转录病毒疗法 (ART) 的出现改变了数百万 HIV 感染者的预后，使得 HIV 感染的诊断不再自动意味着死亡。然而，艾滋病毒感染者的发病率和死亡率仍然很高。HIV 可直接感染肾脏，导致 HIV 相关肾病 (HIVAN)——一种以足细胞和肾小管损伤为特征的疾病，并与肾衰竭风险增加相关。HIVAN 主要发生在非洲血统的报告导致人们发现其与APOL1风险等位基因的关联。ART 的出现导致 HIVAN 患病率大幅下降；然而，有报道称其他肾脏病理学的患病率有所增加，例如局灶节段性肾小球硬化症和与衰老并发症相关的病理学状况，例如高血压和糖尿病。早期开始抗逆转录病毒治疗还会导致药物累积暴露时间更长，从而增加肾毒性的可能性。大量文献支持对艾滋病毒感染者使用肾移植，与接受长期透析的患者相比，肾移植具有显着的生存益处，与艾滋病毒阴性肾移植受者相比，同种异体移植物和患者的长期生存率相似。