Under what circumstances would you consider a kidney biopsy in an HIV patient with subnephrotic range proteinuria, microscopic hematuria, and stable renal function who has been on a tenofovir-based regimen?

I often find the biopsy on these patients unhelpful. Having said that, I do advocate doing a kidney biopsy when there are other circumstances which raise the possibility of other disorders (i.e., possible IgA nephropathy, tenofovir was given for a short period of time, and only TAF was used, etc.).