tsetse fly. Trypanosomes endocytose the secreted form of APOL1; APOL1 forms pores on the lysosomal membranes of the trypanosomes which causes in influx of chloride, swelling of the lysosome and lysis of the trypanosome. Clinical significance African trypanosomiasis (sleeping sickness) Although its intracellular function has not been elucidated, apoL1 circulating in plasma has the ability to kill the trypanosome Trypanosoma brucei that causes sleeping sickness. Recently, two coding sequence variants in APOL1 have been shown to associate with kidney disease in a recessive fashion while at the same time conferring resistance against Trypanosoma brucei rhodesiense. This resistance is due, in part, to decreased binding of the G1 and G2 APOL1 variants to the T. b. rhodesiense virulence factor, serum resistance-associated protein (SRA) as a result of the C-terminal polymorphisms. People who have at least one copy of either the G1 or G2 variant are resistant to infection by trypanosomes, but people who have two copies of either variant are at an increased risk of developing a non-diabetic kidney disease. Kidney disease The distribution of the variants most associated with kidney disease risk was analyzed in African populations and found to be more prevalent in western compared to northeastern African populations and absent in Ethiopia, consistent with the reported protection from forms of kidney disease known to be associated with the APOL1 variants. In the Yoruba people of Nigeria (West Africa), the prevalence of G1 and G2 risk alleles are 40% and 8% respectively. African nations with high frequencies of APOL1 risk alleles also have large populations of Trypanosomes suggesting that the risk alleles underwent positive selection as a defense mechanism. The existence of these variants are only found on African chromosomes and exist in people with recent African ancestry (<10,000 years). Many African Americans are descendants of people of West African nations and consequently, also have a high prevalence of APOL1 risk alleles as well as APOL1 associated kidney diseases. The frequency of the risk alleles in African Americans is more than 30%. The existence of these alleles has been shown to increase the risk of developing diseases such as Focal Segmental Glomerulosclerosis(FSGS), Hypertension Attributed-End Stage Kidney Disease (ESKD), and HIV-Associated Nephropathy(HIVAN). The prevalence of the risk alleles in African Americans with these kidney diseases shown in recent studies are 67% in HIVAN, 66% in FSGS, and 47% in hypertension-attributed ESKD. Hispanic populations such as Dominicans and Puerto Ricans demonstrate