Human Immune Deficiency Virus (HIV) is a highly adaptive and fast-evolving virus associated with renal damage, affecting kidney structures directly and indirectly. A cytopathic impact and immune complexes mediated mechanisms were suggested. Furthermore, nephrotoxic drugs, including antiviral therapy, and coinfections, have a role in kidney damage. Additionally, HIV patients live longer, increasing the chance of comorbid chronic diseases that increase kidney damage risk. Chronic kidney disease (CKD) progresses and might cause end-stage renal disease (ESRD), especially in HIV. HIV-AN prediction is possible by apolipoprotein-1 (APOL-1) polymorphism detection, high viral load, and proteinuria. Kidney transplantation is possible in HIV-AN if the infection is controlled. The exact mechanism(s) of HIV-AN pathogenesis is not established. Hence, an updated clinical review article about the HIV-AN pathogenesis and management was planned. EMBASE, Google Scholar, Google, Scopus, and PubMed sites were searched for pathogenesis, diagnosis markers, and predictors of HIV-AN. We used keywords and phrases such as HIV-related kidney diseases, HIV-associated nephropathy, HIV-AN, interstitial, tubular, and glomerular diseases in HIV, gene abnormalities and HIV-AN, Kidney disease treatment or management in HIV, and CKD pathogenesis in HIV.