Optimal Management of HIV Infected Adults at Risk for Kidney Complications in Nigeria

Inclusion criteria: * Participated in Study Aim 1 * 18-70 years of age * HIV-positive (as documented by HIV-1 ELISA testing) * On ART for a minimum of six (6) months AND having a suppressed plasma viral load result (\< 20 copies/mL) within the past 6 months * Average uACR between 30-300 mg/g (based on 2 uACRs \[first morning voids\], with the second obtained 4-8 weeks after the first specimen)(NOTE: All aim 1 screened patients having a uACR value \> 300 mg/g will undergo urine dipstick analysis for aim 2 eligibility, and if their urine dipstick results reveals ≥ 2+ protein, then they will be considered ineligible (no additional uACR testing will be necessary to determine eligibility) * eGFR = \>60 ml/min/1.73m2 (using CKD-EPI-Cr-CyC equation) AND * If female, non-pregnant (documentation of negative urine pregnancy test) and not breastfeeding/lactating Exclusion criteria: * Pregnant or currently breastfeeding * eGFR of \<60 ml/min/1.73m2 (using CKD-EPI-Cr-CyC equation) * Average uACR \> 300 mg/g (based on 2 uACRs \[first morning voids\], with the second obtained 4-8 weeks after the first specimen) * K+ \>5.0 meEq/L or reasons to be concerned about hyperkalemia * Known history of Diabetes diabetes mellitus (would qualify for treatment with an ACEi/ARB) * Poorly controlled hypertension (≥3 BP readings \>160/110 in past 3 6 months) * Known history of Congestive congestive heart failure (chronic) * Average uACR (calculated on values obtained from 2 successive measures 4-8 weeks…