APOL1 and focal segmental glomerulosclerosis: ,7 Homozygosity (or compound heterozygosity) for APOL1 genetic variants which provide protection against Trypanosoma brucei infection is a major risk factor for the development of HIV-associated nephropathy, focal and segmental glomerulosclerosis, progressive CKD, and ESKD.8, 9, 10 An estimated one-third of CKD and half of ESKD cases in people of African ancestry with HIV may be attributable to APOL1 high-risk genotypes.10