{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T10:55:35Z","timestamp":1790679335780,"version":"4.1.0"},"reference-count":57,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000735","name":"University of Cambridge","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000735","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      To review the pathogenesis, epidemiology, clinical presentation, management and outcomes of HIV\u2010associated nephropathy (HIVAN), with emphasis on global disparities, genetic susceptibility (\n                      <jats:italic>APOL1<\/jats:italic>\n                      ) and emerging therapeutic and technological advances.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Narrative literature review synthesizing contemporary evidence from clinical cohorts, translational research and guideline\u2010based practice, with comparative perspectives from high\u2010resource (UK) and low\u2010resource (sub\u2010Saharan Africa) settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Relevant studies were analysed to evaluate mechanisms of disease, epidemiological trends, diagnostic approaches, treatment strategies and long\u2010term outcomes. Particular focus was placed on\n                      <jats:italic>APOL1<\/jats:italic>\n                      \u2010associated risk, antiretroviral therapy (ART) impact and recent developments including artificial intelligence (AI) applications and targeted therapies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      HIVAN arises from direct HIV infection of renal epithelial cells in genetically susceptible individuals, particularly those with\n                      <jats:italic>APOL1<\/jats:italic>\n                      risk variants. ART has significantly reduced incidence in high\u2010income settings, whereas HIVAN remains prevalent in sub\u2010Saharan Africa due to delayed diagnosis and limited healthcare access. Clinically, HIVAN presents with proteinuria and progressive kidney dysfunction, requiring biopsy for confirmation. Early ART initiation improves renal outcomes, supported by adjunctive therapies such as renin\u2010angiotensin system blockade and SGLT2 inhibitors. Emerging therapies targeting\n                      <jats:italic>APOL1<\/jats:italic>\n                      and advances in AI\u2010driven risk prediction and diagnostics show promise.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      HIVAN reflects an interplay between viral, genetic and socio\u2010economic factors. While ART has transformed outcomes in well\u2010resourced settings, significant global disparities persist. Future progress depends on improving HIV care access, expanding renal services and advancing precision medicine approaches, including\n                      <jats:italic>APOL1<\/jats:italic>\n                      \u2010targeted therapies and AI\u2010enabled risk stratification.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hiv.70315","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T09:58:06Z","timestamp":1790675886000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["<scp>HIV<\/scp>\n                    \u2010associated nephropathy: A decade of clinical outcomes, global disparities and emerging promise"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-2976-1892","authenticated-orcid":false,"given":"Deepak V.","family":"Pathiyil","sequence":"first","affiliation":[{"name":"Department of Medicine University of Cambridge  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