Objective    To describe the presentation, pathology, and outcome of biopsy proved renal disease in HIV infected patients.    Methods    This retrospective study included all HIV infected patients who underwent renal biopsy during the course of their clinical care at PUMC hospital from 2002 to 2012. The pathology and clinical information were abstracted from each patient’s clinical record.    Results    Eight HIV infected patients had biopsy confirmed renal disease. The commonest presentation was proteinuria in eight patients, and microscopic hematuria in six patients. Two patients had serum creatinine levels abnormal. Renal pathologies included IgA nephropathy in four patients, and lupus-like nephropathy, non-specific focal segmental glomerulosclerosis, membranous nephropathy and Henoch-Schonlein purpura nephritis in one patient each. All 8 patients received highly active antiretroviral treatment (HAART). Urinary protein was decreased significantly in one of them. Another was relieved with ACEI/ARB in addition to HAART. Corticosteroid was given to the other 6 patients. Among them, two got remission. one presented no reaction and was given cyclosporine. One, whose urinary protein didn't decrease with ACEI/ARB, received corticosteroid and needed further observation. One had continued aggravation of the renal disease. One case died of AIDS. One case companied with IgA nephropathy whose proteinuria recurrence was considered having association with tenofovir renal toxicity relieved after adjustment of HAART.    Conclusions    Classical HIVAN is uncommon in Chinese HIV infected population, a variety of other pathologies were seen in HIV infected patients, renal biopsy can help confirm the diagnosis. In HIV infected patients with evidence of nephropathy should be treated with HAART at diagnosis. Addition of prednisone should be considered if HAART alone does not result in improvement of renal disease.