Is leishmaniasis ever cured?

Rossell, Raiza Aragort De; DuráN, R. De Jesús De; Rossell, Osman; Rodrı́guez, Ana

doi:10.1016/0035-9203(92)90297-p

Cited by 59 publications

(30 citation statements)

References 12 publications

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“…Leishmania infection is a persistent disorder, although a clinical cure may be achieved using adequate treatment (1,9). Because of this, a previous diagnosis of symptomatic VL was found to be associated with the development of kala-azar on the univariate analysis.…”

Section: Discussionmentioning

confidence: 99%

Incidence of and Risk Factors for Symptomatic Visceral Leishmaniasis among Human Immunodeficiency Virus Type 1-Infected Patients from Spain in the Era of Highly Active Antiretroviral Therapy

et al. 2002

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The way in which the extensive use of highly active antiretroviral therapy (HAART) has influenced the incidence of visceral leishmaniasis (VL) among human immunodeficiency type 1 (HIV-1)-infected patients is not yet understood. The present study assessed whether the incidence of symptomatic VL in HIV-infected patients has decreased since the introduction of HAART. Likewise, the role of other potential risk factors for VL was also analyzed. Therefore, 479 HIV-1-infected patients receiving antiretroviral treatment, according to the available drugs at each moment, were prospectively followed from April 1989 to June 2000 in two university hospitals in southern Spain. A bone marrow aspiration was performed when patients showed symptoms suggestive of kala-azar. A diagnosis of VL was made when Leishmania amastigotes were seen in Giemsa-stained samples or promastigotes were cultured in specific media. The median follow-up time was 1,380 [8 to 4,536] days. Twenty-one patients were diagnosed with symptomatic VL. The density of incidence of VL has decreased 64.8% as of January 1997, when HAART began to be used extensively in our area. The use of HAART was the main independent factor associated with VL; this therapy was a protective factor (adjusted hazard ratio [HR], 0.05; 95% confidence interval [CI], 0.02 to 0.15). CDC clinical category C at entry in the cohort (HR, 4.08; 95% CI, 1.46 to 11.35) and CD4؉ cell counts below 300 cells/mm 3 during the follow-up (HR, 3.96; 95% CI, 1.56 to 10.01) were also independently associated with kala-azar. A VL diagnosis prior to follow-up and low compliance with antiretroviral therapy were not independently associated with symptomatic VL, although statistical significance was almost reached (P ‫؍‬ 0.1 and P ‫؍‬ 0.08, respectively). In summary, the use of HAART has led to a fall in the incidence of symptomatic VL in HIV-infected patients. The main risk factor associated with kala-azar emergence in patients infected with HIV is deep immunosuppression.

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Section: Discussionmentioning

confidence: 99%

Incidence of and Risk Factors for Symptomatic Visceral Leishmaniasis among Human Immunodeficiency Virus Type 1-Infected Patients from Spain in the Era of Highly Active Antiretroviral Therapy

et al. 2002

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“…In additon, Rolland-Burger et al (28) found that the sera of patients with visceral leishmaniasis reacted to a 119-kDa band when L. infantum was used as the antigen. If antibodies remain in the patient for years and the patient's serum has a Western blot pattern similar to the one obtained at the time of diagnosis, then serious doubts arise as to whether a patient is ever completely cured (i.e., the patient has no remaining parasites) or whether treatment has induced a chronic subpatent infection, leaving the patient susceptible to relapse later on; for example, immunosuppression can lead to the reemergence of (1,3,8). A test as sensitive as Western blotting may be able to identify immunosuppressed patients who could be at risk of a relapse of leishmaniasis.…”

Section: Discussionmentioning

confidence: 99%

Immunoblot Analysis of the Humoral Immune Response toLeishmania donovaniPolypeptides in Cases of Human Visceral Leishmaniasis: Its Usefulness in Prognosis

Kumar

Pai²,

Tripathi

et al. 2002

Clin Vaccine Immunol

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Sera from Indian patients with parasitologically confirmed visceral leishmaniasis were studied by immunoblot analysis in order to identify a specific pattern for Leishmania infection. A soluble extract of Leishmania donovani was used as antigen. At diagnosis the sera from patients with visceral leishmaniasis specifically recognized fractions represented by bands of 201 kDa (50% of serum samples), 193 kDa (60%), 147 kDa (50%), 120 kDa (60%), 100 kDa (50%), 80 kDa (80%), 70 kDa (70%), 65 kDa (100%), 50 kDa (50%), 36 kDa (50%), 20 kDa (70%), and 18 kDa (50%). The 65-kDa band, common to all patients infected with Leishmania parasites, was found at the time of diagnosis. However, the immunoblot pattern changed after patients were treated and cured with sodium antimony gluconate (SAG; n ‫)01؍‬ or miltefosine (n ‫,)01؍‬ as was evident from blots of sera obtained pretreatment and at 1, 3, and 6 months posttreatment. At 6 months posttreatment, immunoblots of sera from patients on the SAG regimen showed the disappearance of all bands except the 70-kDa band. Similarly, sera from those on the miltefosine regimen showed the disappearance of all bands except the 65-and 70-kDa bands. This study shows that Western blot analysis is a sensitive test for detection of anti-Leishmania antibodies. Moreover, the persistence of reactivity with the 65-and 70-kDa bands in the sera of all groups shows its promise as a diagnostic and prognostic tool.

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“…Geralmente, as preparações vegetais são utilizadas por via oral ou tópica sobre as lesões cutâneas (Netto et al, 1985;Iwu et al, 1994;Akendengue et al, 1999). Porém, esses tratamentos são empíricos e pouco se sabe sobre sua real efi cácia, uma vez que na LTA pode ocorrer a cura espontânea das lesões (Marsden et al, 1984;Costa et al, 1990;Rossel et al, 1992;Marsden, 1994).…”

Section: Introductionunclassified

Efeito leishmanicida in vitro de Stachytarpheta cayennensis (Rich.) Vahl (Verbenaceae)

Moreira¹,

Costa²,

Lopes³

et al. 2007

Rev. bras. farmacogn.

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RESUMO:ABSTRACT: "In vitro leishmanicidal effect of Stachytarpheta cayennensis (Rich.) Vahl (Verbenaceae)". Leishmanicidal activity of the hydroalcoholic extract of Stachytarpheta cayennensis, species that is usually employed in ulcers caused by Leishmania, was evaluated in vitro using Leishmania braziliensis and L. amazonensis promastigotes forms. The hydroalcoholic extract was prepared from dried leaves and used in L. amazonensis and L. braziliensis promastigotes cultures at concentrations of 500 to 32.5 g/mL. After 24 hours the promastigotes forms were quantifi ed and the IC 50 was calculated. The cytotoxicity of the extract was evaluated using peritoneal macrophages. The extract presented a dose and specie-dependent leishmanicidal effect to Leishmania promastigotes, mainly to the L. braziliensis ones. The cytotoxic effect was not observed in macrophage cultures. In conclusion, the hydroalcoholic extract of S. cayennensis inhibits the growing of Leishmania promastigotes forms in vitro accounting for the folk use of this vegetal in skin ulcers caused by Leishmania.

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Is leishmaniasis ever cured?

Cited by 59 publications

References 12 publications

Incidence of and Risk Factors for Symptomatic Visceral Leishmaniasis among Human Immunodeficiency Virus Type 1-Infected Patients from Spain in the Era of Highly Active Antiretroviral Therapy

Incidence of and Risk Factors for Symptomatic Visceral Leishmaniasis among Human Immunodeficiency Virus Type 1-Infected Patients from Spain in the Era of Highly Active Antiretroviral Therapy

Immunoblot Analysis of the Humoral Immune Response toLeishmania donovaniPolypeptides in Cases of Human Visceral Leishmaniasis: Its Usefulness in Prognosis

Efeito leishmanicida in vitro de Stachytarpheta cayennensis (Rich.) Vahl (Verbenaceae)

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