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A 46-year-old man presented to the emergency department with a 2-week history of diarrhea, nausea, abdominal pain, and weakness along with a weight loss of 8 kg in the preceding 2 months. An enzyme-linked immunosorbent assay for the human immunodeficiency virus was positive. Laboratory studies revealed a serum creatinine level of 2.4 mg per deciliter. What is the diagnosis?

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