Visceral leishmaniasis and HIV coinfection in East Africa

Ermias Diro; Lutgarde Lynen; Koert Ritmeijer; Marleen Boelaert; Asrat Hailu; Johan van Griensven

doi:10.1371/journal.pntd.0002869

Visceral leishmaniasis and HIV coinfection in East Africa

Ermias Diro, Lutgarde Lynen, Koert Ritmeijer, Marleen Boelaert, Asrat Hailu, Johan van Griensven

HIV and Tuberculosis

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Abstract

Visceral Leishmaniasis (VL) is an important protozoan opportunistic disease in HIV patients in endemic areas. East Africa is second to the Indian subcontinent in the global VL caseload and first in VL-HIV coinfection rate. Because of the alteration in the disease course, the diagnostic challenges, and the poor treatment responses, VL with HIV coinfection has become a very serious challenge in East Africa today. Field experience with the use of liposomal amphotericin B in combination with miltefosine, followed by secondary prophylaxis and antiretroviral drugs, looks promising. However, this needs to be confirmed through clinical trials. Better diagnostic and follow-up methods for relapse and prediction of relapse should also be looked for. Basic research to understand the immunological interaction of the two infections may ultimately help to improve the management of the coinfection.

Original language	English
Journal	PLoS Neglected Tropical Diseases
Volume	8
Issue number	6
Pages (from-to)	e2869
ISSN	1935-2727
DOIs	https://doi.org/10.1371/journal.pntd.0002869
Publication status	Published - 2014

Keywords

Africa, Eastern
Amphotericin B
Anti-Retroviral Agents
Antiprotozoal Agents
Coinfection
HIV Infections
Humans
Visceral leishmaniasis
Phosphorylcholine
Prevalence

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title = "Visceral leishmaniasis and HIV coinfection in East Africa",

abstract = "Visceral Leishmaniasis (VL) is an important protozoan opportunistic disease in HIV patients in endemic areas. East Africa is second to the Indian subcontinent in the global VL caseload and first in VL-HIV coinfection rate. Because of the alteration in the disease course, the diagnostic challenges, and the poor treatment responses, VL with HIV coinfection has become a very serious challenge in East Africa today. Field experience with the use of liposomal amphotericin B in combination with miltefosine, followed by secondary prophylaxis and antiretroviral drugs, looks promising. However, this needs to be confirmed through clinical trials. Better diagnostic and follow-up methods for relapse and prediction of relapse should also be looked for. Basic research to understand the immunological interaction of the two infections may ultimately help to improve the management of the coinfection.",

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AU - Hailu, Asrat

AU - van Griensven, Johan

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N2 - Visceral Leishmaniasis (VL) is an important protozoan opportunistic disease in HIV patients in endemic areas. East Africa is second to the Indian subcontinent in the global VL caseload and first in VL-HIV coinfection rate. Because of the alteration in the disease course, the diagnostic challenges, and the poor treatment responses, VL with HIV coinfection has become a very serious challenge in East Africa today. Field experience with the use of liposomal amphotericin B in combination with miltefosine, followed by secondary prophylaxis and antiretroviral drugs, looks promising. However, this needs to be confirmed through clinical trials. Better diagnostic and follow-up methods for relapse and prediction of relapse should also be looked for. Basic research to understand the immunological interaction of the two infections may ultimately help to improve the management of the coinfection.

AB - Visceral Leishmaniasis (VL) is an important protozoan opportunistic disease in HIV patients in endemic areas. East Africa is second to the Indian subcontinent in the global VL caseload and first in VL-HIV coinfection rate. Because of the alteration in the disease course, the diagnostic challenges, and the poor treatment responses, VL with HIV coinfection has become a very serious challenge in East Africa today. Field experience with the use of liposomal amphotericin B in combination with miltefosine, followed by secondary prophylaxis and antiretroviral drugs, looks promising. However, this needs to be confirmed through clinical trials. Better diagnostic and follow-up methods for relapse and prediction of relapse should also be looked for. Basic research to understand the immunological interaction of the two infections may ultimately help to improve the management of the coinfection.

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KW - Amphotericin B

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KW - Antiprotozoal Agents

KW - Coinfection

KW - HIV Infections

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KW - Visceral leishmaniasis

KW - Phosphorylcholine

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Visceral leishmaniasis and HIV coinfection in East Africa

Abstract

Keywords

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