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AA-amyloidosis caused by visceral leishmaniasis in a human immunodeficiency virus-infected patient.

de Vallière, S; Mary, C; Joneberg, JE; Rotman, S; Bullani, R; Greub, G; Gillmore, JD; ... Tarr, PE; + view all (2009) AA-amyloidosis caused by visceral leishmaniasis in a human immunodeficiency virus-infected patient. Am J Trop Med Hyg , 81 (2) pp. 209-212.

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Abstract

AA-amyloidosis in the setting of chronic visceral leishmaniasis (VL) has been reported in animal models but documentation in humans is unavailable. Here, we report on a Portuguese man who in 1996 was diagnosed with both human immunodeficiency virus (HIV)-infection and VL. Antiretroviral treatment led to sustained suppression of HIV viremia but CD4+ lymphocytes rose from 8 to only 160 cells/mL. Several courses of antimony treatment did not prevent VL relapses. Renal failure developed in 2006 and renal biopsy revealed AA-amyloidosis. The patient had cryoglobulinemia and serum immune complexes containing antibodies directed against seven leishmanial antigens. Antimony plus amphotericin B, followed by oral miltefosine resulted in a sustained VL treatment response with elimination of circulating Leishmania infantum DNA and CD4+ recovery. The concomitant reduction of serum AA levels and disappearance of circulating leishmanial immune complexes suggests that prolonged VL may lead to AA-amyloidosis in immunocompromised humans.

Type: Article
Title: AA-amyloidosis caused by visceral leishmaniasis in a human immunodeficiency virus-infected patient.
Location: United States
Keywords: Amphotericin B, Amyloidosis, Anti-HIV Agents, Antiprotozoal Agents, HIV Infections, Humans, Leishmaniasis, Visceral, Male, Meglumine, Meglumine Antimoniate, Organometallic Compounds, Young Adult
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Inflammation
URI: http://discovery.ucl.ac.uk/id/eprint/61532
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