<prompt> A 48 year old male who has HIV presents with lab repos showing: Low albumin, massive proteinuria, renal ultrasound showing large, echogenic kidneys. Blood pressure is normal. Which of the following is the most likely cause?Minimal change diseaseIgA nephropathyFocal segmental glomerulosclerosisMembranoproliferavtive glomerulonephritis  <response>: This patient with HIV presents with massive protienuria and hypoalbuminemia, suggestive of HIV-1-associated nephropathy HIVAN - A form of Focal segmental glomerulosclerosis FSGS. Proteinuria is the hallmark of this disorder. Edema and hypeension are rare. A definitive diagnosis is obtained through renal biopsy. Histologically, focal segmental glomerulosclerosis is present in 80, and mesangial proliferation in 10-15 of cases. Reference: Ananthanarayan and Paniker;s Textbook of Microbiology Tenth edition 