Post-kala-azar Dermal Leishmaniasis During Highly Active Antiretroviral Therapy in an AIDS Patient Infected withLeishmania infantum

Ridolfo, Anna Lisa; Gervasoni, Cristina; Antinori, Spinello; Pizzuto, Massimo; Santambrogio, Sara; Trabattoni, Daria; Clerici, Mario; Galli, Massimo

doi:10.1053/jinf.1999.0630

Cited by 54 publications

(67 citation statements)

References 17 publications

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“…27,[44][45][46][47][48][49] In our patients, we observed consistently low CD4 cell counts and high parasitic loads in splenic and bone marrow aspirates and skin lesions, which suggestes that immunosuppression enables the parasites to multiply in the periphery. Therefore, we prefer to consider the cases described herein as cutaneous dissemination of visceral disease.…”

Section: Discussionsupporting

confidence: 61%

Disseminated Cutaneous Leishmaniasis Resembling Post-Kala-Azar Dermal Leishmaniasis Caused by Leishmania donovani in Three Patients Co-Infected with Visceral Leishmaniasis and Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome in Ethiopia

Gelanew¹,

Hurissa²,

Diro³

et al. 2011

The American Society of Tropical Medicine and Hygiene

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We report paired strains of Leishmania parasites, one from the viscera and the other from skin lesions that were isolated from three patients with visceral leishmaniasis and disseminated cutaneous leishmaniasis that were co-infected with human immunodeficiency virus. The causative parasites were characterized by polymerase chain reaction–restriction length polymorphism of the ribosomal DNA internal transcribed spacer 1 and by a panel of multilocus microsatellite markers. We demonstrated that the causative agent was Leishmania donovani in all cases, irrespective of the phenotype of the disease. The paired strains from viscera and skin lesions of the same patients showed genetic identity across the 14 microsatellite markers investigated. These findings demonstrate that the skin lesions in these human immunodeficiency virus–positive patients with visceral leishmaniasis were caused by dissemination of viscerotropic L. donovani parasites as a consequence of severe immunosuppression. However, in all three patients, rapid clearance of the skin lesions was observed after antimonial therapy.

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Section: Discussionsupporting

confidence: 61%

Disseminated Cutaneous Leishmaniasis Resembling Post-Kala-Azar Dermal Leishmaniasis Caused by Leishmania donovani in Three Patients Co-Infected with Visceral Leishmaniasis and Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome in Ethiopia

Gelanew¹,

Hurissa²,

Diro³

et al. 2011

The American Society of Tropical Medicine and Hygiene

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“…It is unclear whether these are forms of PKDL or parasitized skin lesions formed during the course of VL. In addition, an association between PKDL and immune reconstitution disease (IRD) soon after the start of HAART has been described (26,103,208). Interestingly, PKDL-IRD also occurs after VL caused by L. chagasi (38) and L. infantum (47,208,249), which are usually not associated with PKDL.…”

Section: Pkdl and Hiv Coinfectionmentioning

confidence: 99%

“…Furthermore, first episodes of VL were described for three severely immunocompromised patients, all with undetectable viral loads, who had just started HAART (122). A few possible cases of IRD with DCL (192), CL (128), and PKDL (26,103,208) have been described.…”

Section: Ird In Leishmania-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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“…Dereure et al (4) were the first to identify an L. infatum strain from a PKDL case using starch gel electrophoresis and isoelectrofocusing. The only additional report is a case of PKDL caused by L. infantum that was confirmed by molecular testing in a woman with AIDS which occurred 13 months after a diagnosis of visceral leishmaniasis concomitantly with immunological recovery induced by highly active retroviral therapy (13).…”

Section: Discussionmentioning

confidence: 97%

“…1). In spite of the fact that there are many reports about the association between VL and HIV infection, PKDL is rare in HIV-infected patients, with only a few cases reported in the literature (2,6,13,14). PKDL is frequently associated with L. donovani, while the association of PKDL with L. infantum is controversial, with only two cases reported in the literature.…”

Section: Discussionmentioning

confidence: 99%

Post-Kala-Azar Dermal Leishmaniasis Due to Leishmania infantum in a Human Immunodeficiency Virus Type 1-Infected Patient

et al. 2006

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We report the first case of post-kala-azar dermal leishmaniasis due to Leishmania infantum in a human immunodeficiency virus type 1-infected patient in Australia. Molecular characterization of the isolate was performed using PCR restriction fragment length polymorphism targeting both repetitive sequences from Leishmania nuclear DNA and repetitive kinetoplast DNA minicircles for species differentiation.

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Post-kala-azar Dermal Leishmaniasis During Highly Active Antiretroviral Therapy in an AIDS Patient Infected withLeishmania infantum

Cited by 54 publications

References 17 publications

Disseminated Cutaneous Leishmaniasis Resembling Post-Kala-Azar Dermal Leishmaniasis Caused by Leishmania donovani in Three Patients Co-Infected with Visceral Leishmaniasis and Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome in Ethiopia

Disseminated Cutaneous Leishmaniasis Resembling Post-Kala-Azar Dermal Leishmaniasis Caused by Leishmania donovani in Three Patients Co-Infected with Visceral Leishmaniasis and Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome in Ethiopia

The Relationship between Leishmaniasis and AIDS: the Second 10 Years

Post-Kala-Azar Dermal Leishmaniasis Due to Leishmania infantum in a Human Immunodeficiency Virus Type 1-Infected Patient

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