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HIVAN, the commonest renal complication of HI V/ .-\IDS is most prevalent among blacks of African descent. Before the advent of HAART, HIVAN was inevitably fatal within a short period. However, with the introduction of highly active anti-retroviral therapy .H:\ART), the prognosis of HI VAN has dramatically improved. Angiotensin-converting enzyme (ACE) inhibitors and corticosteroids have also improved the treatment outcome of HI VAN. Patients with HIVAN are now being offered renal replacement therapy .dialysis and transplantation) more readily than in the past and new therapeutic strategies against HIVAN are being devised. The racial predilection of HIVAN however, warrants further investigation.