HIV associated nephropathy can present as heavy proteinuria and or advanced renal insufficiency leading to dialysis dependent renal failure. We to report the clinical and histopathological outcome in one patients when HIV disease manifested as HIV nephropathy. A 31 years black male developed progressive renal failure within six weeks creatinine increased from 1.2 mg/dl to 3.17 mg/dl. Evaluation revealed HIV antibody positive with CD4 251/ul and nephrotic proteinuria. Renal biopsy showed collapsing glomerulopathy, microcystic dilatation of tubules. The clinical presentation, physiopatology and probable treatment are discussed. (Rev Med Hered 2004; 15: 51-54).