Impact of a co-factor on the dynamics of<i>Leishmania donovani</i>infection: does HIV infection encourage the recurrence of visceral leishmaniasis following post-kala-azar dermal leishmaniasis?

Nandy, Abhishek; Addy, Manjulika; Maji, Ardhendu Kumar; Guha, Subhasish Kamal

doi:10.1179/000349804225021352

Cited by 1 publication

(1 citation statement)

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“…The majority of patients were men (86.1%), with a median age of 35.5 years (IQR 29.5–42). Group 1 ([6,10–25], cases 1 and 3) included 20 patients (55.6%), group 2 ([23,26–36], case 2) included 16 patients (44.4%). Patients from group 1 originated mostly from Europe, whereas patients from group 2 were mostly from Central or South America, East Africa and India.…”

Section: Resultsmentioning

confidence: 99%

Immune recovery-related patterns of post kala-azar dermal and ocular leishmaniasis in people living with HIV

Rousset

Zenou

Saunier³

et al. 2022

Aids

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Objective:Post kala-azar dermal leishmaniasis (PKDL) is a rare complication of visceral leishmaniasis. We aimed at reporting PKDL cases in people living with HIV (PLHIV) and compare their characteristics based on whether PKDL occurred in the context of immune recovery under antiretroviral therapy (ART) or not.Design:National survey and literature review.Methods:We called for observations in France in October 2020 and performed a literature review from PubMed (Medline) and Web of Science up to December 2020. Two groups of patients were defined based on whether PKDL occurred in the context of immune recovery under ART (group 1) or not (group 2), and compared.Results:Three PLHIV with PKDL identified in France in the last decade were described and added to 33 cases from the literature. Compared with group 2 (16/36, 44.4%), patients from group 1 (20/36, 55.6%) originated more frequently from Europe (12/20, 60% vs. 2/16, 12.5%; P = 0.0038), had higher median blood CD4+ cell counts (221/μl vs. 61/μl; P = 0.0005) and increase under ART (122/μl, interquartile range 73–243 vs. 33/μl, interquartile range 0–53; P = 0.0044), had less frequently concomitant visceral leishmaniasis (3/20, 15% vs. 8/12, 66.7%; P = 0.006), and a trend to more frequent ocular involvement (7/20, 35% vs. 1/16, 6.25%; P = 0.0531).Conclusion:In PLHIV, PKDL occurs after a cured episode of visceral leishmaniasis as part of an immune restoration disease under ART, or concomitant to a visceral leishmaniasis relapse in a context of AIDS. For the latter, the denomination ‘disseminated cutaneous lesions associated with visceral leishmaniasis’ seems more accurate than PKDL.

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Section: Resultsmentioning

confidence: 99%