title: Visceral leishmaniasis due to Leishmania infantum with renal involvement in HIV-infected patients.
abstract: BACKGROUND
  We describe histological, clinical findings and outcomes of renal involvement during Leishmania infantum infection in four HIV-infected patients in South France and North Italy hospital settings.
  
  
  METHODS
  Four HIV-infected Caucasian patients (age 24-49) performed renal biopsy during episodes of visceral leishmaniasis. They presented severe immunosuppression, frequent relapses of visceral leishmaniasis during a follow-up period of several years and partial or complete recovery of renal function after anti-parasitic treatment. Main clinical presentations were nephrotic or nephritic syndrome and/or acute renal failure secondary to membranoproliferative type III glomerulonephritis or acute interstitial nephritis. Clinical outcome was poor, probably as a consequence of insufficient immuno-virological control of the HIV infection.
  
  
  CONCLUSIONS
  Our findings suggest that the main histological findings in case of renal involvement due to Leishmania infantum infection in HIV-infected patients are type III MPGN and acute interstitial nephritis, with a histological specificity similar to that observed in canine leishmaniasis. Poor immune status in HIV-infected patients, altering the capacity for parasite clearance, and prolonged course of chronic active VL in this population may lead to the development of specific renal lesions.
authors.affiliation: Department of Internal Medicine, Cannes General Hospital, Cannes, France. m.vassallo@ch-cannes.fr.
authors.forename: Matteo
authors.initials: M
authors.lastname: Vassallo
authors.affiliation: Department of Nephrology, Dialysis and Transplantation, Nice University Hospital, Nice, France. moranne.o@chu-nice.fr.|Department of Public Health, Nice University Hospital, Nice, France. moranne.o@chu-nice.fr.|Laboratory of Human Motricity, Education and Health (LAMHESS), University of Nice Sophia-Antipolis, Nice, France. moranne.o@chu-nice.fr.
authors.forename: Olivier
authors.initials: O
authors.lastname: Moranne
authors.affiliation: Department of Histopathology, Nice University Hospital, Nice, France. ambrosetti.d@chu-nice.fr.
authors.forename: Damien
authors.initials: D
authors.lastname: Ambrosetti
authors.affiliation: Department of Internal Medicine, Nice University Hospital, Nice, France. jeandel.py@chu-nice.fr.
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Jeandel
authors.affiliation: Parasitology and Mycology, Nice University Hospital and Inserm U 1065, Nice-Sophia Antipolis University, Equipe 6, Centre Méditerranéen de Médicine Moléculaire, Nice, France. pomares.c@chu-nice.fr.
authors.forename: Christelle
authors.initials: C
authors.lastname: Pomares
authors.affiliation: Department of Nephrology, Dialysis and Transplantation, Nice University Hospital, Nice, France. cassuto.e@chu-nice.fr.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Cassuto
authors.affiliation: Department of Internal Medicine, Cannes General Hospital, Cannes, France. a.boscagli@ch-cannes.fr.
authors.forename: Annick
authors.initials: A
authors.lastname: Boscagli
authors.affiliation: Department of Internal Medicine, Cannes General Hospital, Cannes, France. guillaume.g@chu-nice.fr.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Giraud
authors.affiliation: Department of Internal Medicine, Cannes General Hospital, Cannes, France. n.montagne@ch-cannes.fr.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Montagne
authors.affiliation: Department of Infectious Diseases, Sanremo General Hospital, Sanremo, Italy. chiaradentone@libero.it.
authors.forename: Chiara
authors.initials: C
authors.lastname: Dentone
authors.affiliation: Department of Infectious Diseases, Sanremo General Hospital, Sanremo, Italy. ilariangela@yahoo.it.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Demacina
authors.affiliation: Department of Histopathology, Genoa University Hospital, Genoa, Italy. villaggiob@unige.it.
authors.forename: Barbara
authors.initials: B
authors.lastname: Villaggio
authors.affiliation: Department of Infectious Diseases, Sanremo General Hospital, Sanremo, Italy. Giovanni.secondo2@gmail.com.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Secondo
authors.affiliation: Department of Infectious Diseases, Sanremo General Hospital, Sanremo, Italy. g.ferrea@asl1.liguria.it.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Ferrea
authors.affiliation: Department of Nephrology, Cannes General Hospital, Cannes, France. c.passeron@ch-cannes.fr.
authors.forename: Corinne
authors.initials: C
authors.lastname: Passeron
authors.affiliation: Department of Internal Medicine, Cannes General Hospital, Cannes, France. l.saudes@ch-cannes.fr.
authors.forename: Laurence
authors.initials: L
authors.lastname: Saudes
authors.affiliation: Department of Internal Medicine, Cannes General Hospital, Cannes, France. r.kaphan@ch-cannes.fr.
authors.forename: Regis
authors.initials: R
authors.lastname: Kaphan
authors.affiliation: Parasitology and Mycology, Nice University Hospital and Inserm U 1065, Nice-Sophia Antipolis University, Equipe 6, Centre Méditerranéen de Médicine Moléculaire, Nice, France. marty.p@chu-nice.fr.
authors.forename: Pierre
authors.initials: P
authors.lastname: Marty
authors.affiliation: Department of Internal Medicine, Nice University Hospital, Nice, France. Rosenthal.e@chu-nice.fr.
authors.forename: Eric
authors.initials: E
authors.lastname: Rosenthal
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000150:complications / Q000473:pathology*; D000328:Adult; D005602:France; D006801:Humans; D007558:Italy; D018314:Leishmania infantum; D007898:Leishmaniasis, Visceral / Q000150:complications / Q000473:pathology*; D008875:Middle Aged; D009395:Nephritis, Interstitial / Q000150:complications / Q000473:pathology*