{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T10:39:31Z","timestamp":1763030371928,"version":"3.45.0"},"reference-count":181,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T00:00:00Z","timestamp":1762819200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TropicalMed"],"abstract":"<jats:p>Human Immunodeficiency Virus (HIV) infection is associated with a wide spectrum of urological manifestations, reflecting both the direct effects of viral infection and the indirect consequences of immunosuppression, opportunistic infections, malignancies and long-term combined antiretroviral therapy (cART). This narrative review provides a contemporary, multifaceted overview of the clinical and pathological presentations of urological conditions in people living with HIV (PLWHIV), based on articles published between 1989 and 2025. Conditions discussed include HIV-associated nephropathy (HIVAN), opportunistic genitourinary infections, malignancies such as Kaposi sarcoma and lymphoma, as well as non-infectious complications such as HIV-associated nephropathy and erectile dysfunction (ED). The review highlights the evolving epidemiology of these conditions in the cART era, with a noted decline in opportunistic infections but a rising burden of chronic kidney disease and malignancies, largely due to improved survival and ageing of the HIV-positive population. Pathological insights are explored and discussed, including mechanisms of HIV-associated renal injury, such as direct viral infection of renal epithelial cells and genetic predispositions linked to Apolipoprotein L1 (APOL1) variants. In addition, psychosocial factors, including anxiety, stress, stigma, and alcohol use, are discussed, as they may contribute to late presentation to clinical urology services. The review also considers the challenges faced in low and middle-income countries, the impact of HIV on urological services, and the important role of palliative care in advanced disease. Ultimately, this review underscores the need for early recognition, comprehensive diagnostic and surgical evaluation, and integrated social, psychological, and palliative management strategies tailored to the unique needs of PLWHIV. A deeper understanding of the interplay between HIV, cART, psychosocial determinants, and urological health is essential for improving patient outcomes and guiding future research in this evolving field.<\/jats:p>","DOI":"10.3390\/tropicalmed10110318","type":"journal-article","created":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T08:57:41Z","timestamp":1762851461000},"page":"318","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Contemporary Multidimensional Insight into the Clinical and Pathological Presentation of Urological Conditions Associated with HIV: A Narrative Review"],"prefix":"10.3390","volume":"10","author":[{"given":"Hannah","family":"Faherty","sequence":"first","affiliation":[{"name":"Department of Surgery, Milton Keynes University Hospital NHS Foundation Trust, Milton Keynes MK6 5LD, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jamshaid Nasir","family":"Shahid","sequence":"additional","affiliation":[{"name":"Department of Urology, Bedford Hospital NHS Foundation Trust, Bedford MK42 9DJ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yousef","family":"Abu Osba","sequence":"additional","affiliation":[{"name":"Department of Surgery, Leicester University Hospital, Leicester LE1 5WW, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maryam","family":"Jamshaid","sequence":"additional","affiliation":[{"name":"Department of Surgery, Liverpool University Hospital, Liverpool L7 8YE, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dushyant","family":"Mital","sequence":"additional","affiliation":[{"name":"Department of Blood Borne Virus and HIV, Milton Keynes University Hospital NHS Foundation Trust, Eaglestone, Milton Keynes MK6 5LD, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8045-6996","authenticated-orcid":false,"given":"Mohamed H.","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Department of Geriatric Medicine, Milton Keynes University Hospital NHS Foundation Trust, Eaglestone, Milton Keynes MK6 5LD, UK"},{"name":"Faculty of Medicine and Health Sciences, University of Buckingham, Buckingham MK18 1EG, UK"},{"name":"Department of Medicine and HIV Metabolic Clinic, Milton Keynes University Hospital NHS Foundation Trust, Eaglestone, Milton Keynes MK6 5LD, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,11]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2021). 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