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RESEARCH ARTICLE

Managing two decades of visceral leishmaniasis and HIV co-infection: a case report that illustrates the urgent research needs in the field

Melissa L. Kelly A E , Angie N. Pinto A B , Dan Suan A , Debbie Marriott A , David A. Cooper A B and Sarah L. Pett A B C D

A HIV, Immunology & Infectious Diseases Service, St Vincent’s Hospital, 390 Victoria Street, Darlinghurst, NSW 2010, Australia.

B Kirby Institute, University of NSW, High Street, Kensington, NSW 2052, Australia.

C MRC CTU at UCL, University College London, London, WC2B 6NH, UK.

D Clinical Research Group, Infection and Population Health, UCL, London, WC1E 6JB, UK.

E Corresponding author. Email: Melissa_kelly_@hotmail.com

Sexual Health - http://dx.doi.org/10.1071/SH16036
Submitted: 3 March 2016  Accepted: 16 November 2016   Published online: 9 January 2017

Abstract

Visceral leishmaniasis and HIV co-infection presents diagnostic, monitoring and treatment challenges. This is a report of a co-infected patient who developed multiple complications and treatment side-effects, including renal and liver failure, pancytopenia with recurrent sepsis, along with anal cancer, depression and poor quality-of-life spanning over two decades. Urgent research specific to this cohort is needed.

Additional keywords: Kala-azar, opportunistic infection.


References

[1]  Magill A. Chapter 277: Leishmania species. In Mandell G, Douglas R, Bennett J. Principles and practice of infectious diseases, 8th edn. Philadelphia: Churchill Livingstone; 2015; pp 3091–3107.

[2]  Jarvis J, Lockwood D. Clinical aspects of visceral leishmaniasis in HIV infection. Curr Opin Infect Dis 2013; 26 1–9.
Clinical aspects of visceral leishmaniasis in HIV infection.CrossRef | open url image1

[3]  Word Health Organization. Control of the leishmaniases: report of a meeting of the WHO expert committee on the control of leishmaniases. Geneva: World Health Organization; 2010. Available online at: http://whqlibdoc.who.int/trs/WHO_TRS_949_eng.pdf [verified 8 July 2015].

[4]  Alvar J, Aparicio P, Aseffa A, Den Boer M, Canavate C, Dedet J-P, Gradoni L, Ter Horst R, Lopez-Velez R, Moreno J. The relationship between leishmaniasis and AIDS: the second 10 years. Clin Microbiol Rev 2008; 21 334–59.
The relationship between leishmaniasis and AIDS: the second 10 years.CrossRef | 1:CAS:528:DC%2BD1cXmtFKlsrk%3D&md5=ef30aa075b768b92b1e9f430902169c5CAS | open url image1

[5]  van Griensven J, Balasegaram M, Meheus F, Alvar J, Lynen L, Boelaert M. Combination therapy for visceral leishmaniasis. Lancet Infect Dis 2010; 10 184–94.
Combination therapy for visceral leishmaniasis.CrossRef | 1:CAS:528:DC%2BC3cXntlOhtbg%3D&md5=a0c10112c6d27c217b06d788873a5aa2CAS | open url image1

[6]  Stark D, Pett S, Marriott D, Harkness J. Post-Kala-Azar dermal leishmaniasis due to Leishmania infantum in a human immunodeficiency virus type 1-infected patient. J Clin Microbiol 2006; 44 1178–80.
Post-Kala-Azar dermal leishmaniasis due to Leishmania infantum in a human immunodeficiency virus type 1-infected patient.CrossRef | 1:STN:280:DC%2BD287ivFyhsw%3D%3D&md5=b7cb9d135c363fb0aa3c4ecc970e3558CAS | open url image1

[7]  Barbosa WL, de Araujo P, de Andrade L, dos Santos A, da Silva M, Dantas-Torres F, Medeiros Z. Rapid tests and the diagnosis of visceral leishmaniasis and HIV/AIDS co-infection. Am J Trop Med Hyg 2015; 93 967–9.
Rapid tests and the diagnosis of visceral leishmaniasis and HIV/AIDS co-infection.CrossRef | open url image1

[8]  Ritmeijer K, ter Horst R, Chane S, Aderie E, Pienning T, Collin S, Davidson R. Limited effectiveness of high-dose liposomal amphotericin B (AmBisome) for treatment of visceral leishmaniasis in an Ethiopian population with high HIV prevalence. Clin Infect Dis 2011; 53 e152–8.
Limited effectiveness of high-dose liposomal amphotericin B (AmBisome) for treatment of visceral leishmaniasis in an Ethiopian population with high HIV prevalence.CrossRef | 1:CAS:528:DC%2BC3MXhsVOis7%2FK&md5=ae4a27807626dc1c5b7769613035ce08CAS | open url image1

[9]  Sundar S, Rai M, Chakravarty J, Agarwal D, Agrawal N, Vaillant M, Olliaro P, Murray HW. New treatment approach in Indian visceral leishmaniasis: single dose liposomal amphotericin B follows by short-course oral miltefosine. Clin Infect Dis 2008; 47 1000–6.
New treatment approach in Indian visceral leishmaniasis: single dose liposomal amphotericin B follows by short-course oral miltefosine.CrossRef | 1:CAS:528:DC%2BD1cXhtlSru7nI&md5=7060e8af91f6e72ae6a0578664a8025fCAS | open url image1

[10]  Ermias D. Efficacy trial of Ambisome given alone and Ambisome given in combination with Miltefosine for the treatment of VL HIV positive Ethiopian patients. 2016. Available online at: https://clinicaltrials.gov/ct2/show/NCT02011958 [verified 27 January 2016].

[11]  Mahajan R, Das P, Isaakidis P, Sunyoto T, Sagili KD, Lima MA, Mitra G, Kumar D, Pandey K, Van geertruyden J-P, Boelaert M, Burza S. Combination treatment for visceral leishmaniasis patients co-infected with human immunodeficiency virus in India. Clin Infect Dis 2015; 61 1255–62.
Combination treatment for visceral leishmaniasis patients co-infected with human immunodeficiency virus in India.CrossRef | open url image1

[12]  Diro E, Ritmeijer K, Boelaert M, Alves F, Mohammed R, Abongomera C, Ravinetto R, De Crop M, Fikre H, Adera C, Colebunders R, van Loen H, Menten J, Lynen L, Hailu A, van Griensven J. Use of pentamidine as secondary prophylaxis to prevent visceral leishmaniasis relapse in HIV infected patients, the first twelve months of a prospective cohort study. PLoS Negl Trop Dis 2015; 9 e0004087
Use of pentamidine as secondary prophylaxis to prevent visceral leishmaniasis relapse in HIV infected patients, the first twelve months of a prospective cohort study.CrossRef | open url image1

[13]  de Macedo-Silva S, Urbina J, de Souza W, Rodrigues J. In-vitro activity of the antifungal azoles itraconazole and posaconazole against Leishmania amazonensis. PLoS One 2013; 8 e83247
In-vitro activity of the antifungal azoles itraconazole and posaconazole against Leishmania amazonensis.CrossRef | open url image1

[14]  Paniz Mondolfi AE, Stavropoulos C, Gelanew T, Loucas E, Perez Alvarez AM, Benaim G, Polsky B, Schoenian G, Sordillo EM. Successful treatment of old world cutaneous leishmaniasis caused by Leishmania infantum with posaconazole. Antimicrobial Agent Chemotherapy 2011; 55 1774–76.
Successful treatment of old world cutaneous leishmaniasis caused by Leishmania infantum with posaconazole.CrossRef | 1:STN:280:DC%2BC3M3otF2lsQ%3D%3D&md5=5bf2325cecd5c76970b8e1ca6aef7545CAS | open url image1

[15]  Copeland N, Aronson N. Leishmaniasis: treatment updates and clinical practice guidelines. Curr Opin Infect Dis 2015; 28 426–37.
Leishmaniasis: treatment updates and clinical practice guidelines.CrossRef | 1:CAS:528:DC%2BC2MXhsVeqtrrI&md5=cf067c2ef07b73e543149f83776f79f8CAS | open url image1



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