American cutaneous leishmaniasis due to Leishmania (Viannia) guyanensis as an initial clinical presentation of human immunodeficiency virus infection

Souza, Iliner de Souza e; Naiff, R. D.; Guimarães, Túlio César; Naiff, Marcicleide de Farias; Cupolillo, Elisa; Rodrigues, Wagner de Andrade; Schettini, Antônio Pedro Mendes

doi:10.1016/s0926-9959(98)00011-7

Cited by 20 publications

(6 citation statements)

References 18 publications

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“…The (11 of 17 patients). 3,[12][13][14][15][16][17][18][19][20][21][22] Only two patients had LCL. 3,17 The same is true for cases described in the Old World: only two of the 11 cases reported in Africa and the Middle East were LCL with no mucosal involvement.…”

Section: Discussionmentioning

confidence: 99%

“…29 Seven of the eight previous New World cases for which the species could be identified were caused by L. braziliensis and one was caused by L. guyanensis. 3,[12][13][14][15][16][17][18][19][20][21][22] The third, and most likely, explanation is that the literature is biased by the fact that only unusual and severe cases of HIV-CL coinfection are reported. Our study included all HIVinfected patients with leishmaniasis from the leishmaniasis cohort (1994)(1995)(1996)(1997)(1998)(1999)(2000), regardless of their clinical presentation.…”

Section: Discussionmentioning

confidence: 99%

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Comparative study of cutaneous leishmaniasis in human immunodeficiency virus (HIV)-infected patients and non-HIV-infected patients in French Guiana

et al. 2004

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Comparative study of cutaneous leishmaniasis in human immunodeficiency virus (HIV)-infected patients and non-HIV-infected patients in French Guiana

et al. 2004

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“…Coinfected patients with moderate immunosuppression (CD4 levels above 200 cells/l) had more lesions and a lower rate of recovery after one treatment cycle with pentamidine than their HIV-negative counterparts (66). Relapse was reported after repeated cycles of treatment for one coinfected patient (CD4 count of 582/l) who had mucosal and cutaneous involvement with abundant amastigotes, even in clinically healed lesions, and a negative skin test (84).…”

Section: Cl-hiv Coinfectionmentioning

confidence: 96%

“…Sporadic cases have been described in Brazil (13,42,84) and other South American countries, as well as India (244), Spain (157), and Ethiopia (29). MCL may be severe in HIV-infected patients, with dissemination and a relapsing course.…”

Section: Mcl-hiv Coinfectionmentioning

confidence: 99%

The Relationship between Leishmaniasis and AIDS: the Second 10 Years

et al. 2008

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SUMMARY To date, most Leishmania and human immunodeficiency virus (HIV) coinfection cases reported to WHO come from Southern Europe. Up to the year 2001, nearly 2,000 cases of coinfection were identified, of which 90% were from Spain, Italy, France, and Portugal. However, these figures are misleading because they do not account for the large proportion of cases in many African and Asian countries that are missed due to a lack of diagnostic facilities and poor reporting systems. Most cases of coinfection in the Americas are reported in Brazil, where the incidence of leishmaniasis has spread in recent years due to overlap with major areas of HIV transmission. In some areas of Africa, the number of coinfection cases has increased dramatically due to social phenomena such as mass migration and wars. In northwest Ethiopia, up to 30% of all visceral leishmaniasis patients are also infected with HIV. In Asia, coinfections are increasingly being reported in India, which also has the highest global burden of leishmaniasis and a high rate of resistance to antimonial drugs. Based on the previous experience of 20 years of coinfection in Europe, this review focuses on the management of Leishmania-HIV-coinfected patients in low-income countries where leishmaniasis is endemic.

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“…Lesions may appear on the tongue, buccal mucosa, oropharynx, and larynx [87] , [107] – [112] . Combined CL and mucosal involvement has been described in HIV co-infected patients with L. braziliensis , L. infantum , or L. major infection and L. guyanensis ; the absence of a positive LST should alert one to the possibility of HIV co-infection [38] , [113] – [115] .…”

Section: (Pkdl-like) Dermal Manifestations In Hiv-infected Patients Pmentioning

confidence: 99%

PKDL and Other Dermal Lesions in HIV Co-infected Patients with Leishmaniasis: Review of Clinical Presentation in Relation to Immune Responses

Zijlstra¹

2014

PLoS Negl Trop Dis

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BackgroundCo-infection of leishmaniasis and HIV is increasingly reported. The clinical presentation of leishmaniasis is determined by the host immune response to the parasite; as a consequence, this presentation will be influenced by HIV-induced immunosuppression. As leishmaniasis commonly affects the skin, increasing immunosuppression changes the clinical presentation, such as in post-kala-azar dermal leishmaniasis (PKDL) and cutaneous leishmaniasis (CL); dermal lesions are also commonly reported in visceral leishmaniasis (VL) and HIV co-infection.MethodsWe reviewed the literature with regard to dermal manifestations in leishmaniasis and HIV co-infection, in three clinical syndromes, according to the primary presentation: PKDL, VL, or CL.ResultsA wide variety of descriptions of dermal leishmaniasis in HIV co-infection has been reported. Lesions are commonly described as florid, symmetrical, non-ulcerating, nodular lesions with atypical distribution and numerous parasites. Pre-existing, unrelated dermal lesions may become parasitized. Parasites lose their tropism and no longer exclusively cause VL or CL. PKDL in HIV co-infected patients is more common and more severe and is not restricted to Leishmania donovani. In VL, dermal lesions occur in up to 18% of patients and may present as (severe) localized cutaneous leishmaniasis, disseminated cutaneous leishmaniasis (DL) or diffuse cutaneous leishmaniasis (DCL); there may be an overlap with para-kala-azar dermal leishmaniasis. In CL, dissemination in the skin may occur resembling DL or DCL; subsequent spread to the viscera may follow. Mucosal lesions are commonly found in VL or CL and HIV co-infection. Classical mucocutaneous leishmaniasis is more severe. Immune reconstitution disease (IRD) is uncommon in HIV co-infected patients with leishmaniasis on antiretroviral treatment (ART).ConclusionWith increasing immunosuppression, the clinical syndromes of CL, VL, and PKDL become more severe and may overlap. These syndromes may be best described as VL with disseminated cutaneous lesions (before, during, or after VL) and disseminated cutaneous leishmaniasis with or without visceralization.

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American cutaneous leishmaniasis due to Leishmania (Viannia) guyanensis as an initial clinical presentation of human immunodeficiency virus infection

Cited by 20 publications

References 18 publications

Comparative study of cutaneous leishmaniasis in human immunodeficiency virus (HIV)-infected patients and non-HIV-infected patients in French Guiana

Comparative study of cutaneous leishmaniasis in human immunodeficiency virus (HIV)-infected patients and non-HIV-infected patients in French Guiana

The Relationship between Leishmaniasis and AIDS: the Second 10 Years

PKDL and Other Dermal Lesions in HIV Co-infected Patients with Leishmaniasis: Review of Clinical Presentation in Relation to Immune Responses

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