New insights into leishmaniasis in the immunosuppressed

Hannah Akuffo, Carlos Costa, Johan van Griensven, Sakib Burza, Javier Moreno, Mercè Herrero

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Abstract

Immunosuppression contributes significantly to the caseload of visceral leishmaniasis (VL). HIV coinfection, solid organ transplantation, malnutrition, and helminth infections are the most important immunosuppression-related factors. This review briefly describes the challenges of these associations. East Africa and the Indian subcontinent are the places where HIV imposes the highest burden in VL. In the highlands of Northern Ethiopia, migrant rural workers are at a greater risk of coinfection and malnutrition, while in India, HIV reduces the sustainability of a successful elimination programme. As shown from a longitudinal cohort in Madrid, VL is an additional threat to solid organ transplantation. The association with malnutrition is more complex since it can be both a cause and a consequence of VL. Different regimes for therapy and secondary prevention are discussed as well as the role of nutrients on the prophylaxis of VL in poverty-stricken endemic areas.

Original languageEnglish
Article numbere0006375
JournalPLoS Neglected Tropical Diseases
Volume12
Issue number5
Number of pages16
ISSN1935-2727
DOIs
Publication statusPublished - 2018

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