To determine the value of human immunodeficiency virus type 1 (HIV-1) RNA level in distinguishing HIV-associated nephropathy from non-HIV-associated nephropathy renal pathological conditions, we retrospectively compared renal histopathological findings for 86 HIV-infected patients according to HIV-1 RNA levels. We found that HIV-associated nephropathy was unlikely among patients with HIV-1 RNA levels <400 copies/mL. Hypertensive vascular disease surpassed HIV-associated nephropathy as the most common renal pathological finding among the entire cohort. HIV-1 RNA level did not correlate with renal survival.