Visceral Leishmaniasis and HIV Coinfection in the Mediterranean Region

Monge‐Maíllo, Begoña; Norman, Francesca; Cruz, Israel; Alvar, Jorge; López‐Vélez, Rogelio

doi:10.1371/journal.pntd.0003021

Cited by 109 publications

(104 citation statements)

References 91 publications

(143 reference statements)

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“…Co-infection of leishmaniasis and HIV/AIDS is becoming an important public health problem in different parts of the world (4,9,10) and also in our country (11). Travelers to tropical and subtropical areas (including Mediterranean countries) (8) are at risk of exposure to leishmaniasis, and this parasitic infection should be considered in patients with signs and symptoms of leishmaniasis (e.g., fever with hepatosplenomegaly) and a history of travel to these areas, even up to several months or years before onset of clinical symptoms (12).…”

Section: Epidemiologymentioning

confidence: 99%

Visceral Leishmaniasis: An Update and Literature Review

Karimi

Alborzi

Amanati

2016

Arch Pediatr Infect Dis

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Context: Leishmania is a pathogen that infects mononuclear phagocytes in which they establish chronic intracellular parasitism and survive for the infected person's lifetime. Untreated cases of visceral leishmaniasis (VL) could cause death within two years. Along with known complications of VL, co-infection of Leishmania with human immunodeficiency virus (HIV) is becoming more frequent, with important clinical, diagnostic, chemotherapeutic, epidemiologic, and economic implications. This review attempts to provide updated information about diagnosis and treatment of VL. Evidence Acquisition: In this narrative review, recent published sources of information on leishmaniasis consisting of books and articles have been reviewed. This review focuses on VL. Results: The outcome of infection depends on the host, the Leishmania species, and co-morbidities or co-infections. Disease manifestation may range from asymptomatic carrier to fatal disease. The development of a sensitive and rapid antigen detection test for relapse detection and also for cure remains an important aspect in diagnosis. Conclusions: Development of novel drugs and diagnostic tests has allowed us to better manage VL. Although leishmaniasis is one of the oldest known parasitic infectious diseases, increasing prevalence of VL among specific populations, recent reports of disease reactivation and flare-up in clinically asymptomatic patients after the onset of immunosuppressive therapy, the risk of disease acquisition by tourists in endemic areas (e.g., the Mediterranean eara), and difficulties in prevention and controlling disease (i.e., given the diversity and distribution of vectors and reservoirs), leishmaniasis has again attracted researchers' attention. Concerning reports of treatment failure and drug resistance are also new challenges in management of this parasitic disease in endemic areas.

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Section: Epidemiologymentioning

confidence: 99%

Visceral Leishmaniasis: An Update and Literature Review

Karimi

Alborzi

Amanati

2016

Arch Pediatr Infect Dis

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“…It does not necessarily lead to clinical disease; most infections remain asymptomatic, but malnutrition and immune suppression, notably HIV, predispose to clinical diseases [5]. Cases of Leishmania/HIV coinfection have been reported in the Mediterranean region, mainly in France, Italy, Portugal, and Spain [11]. Since highly active antiretroviral therapy was introduced in 1997, a marked decrease in the number of co-infected cases both in these regions and in India have been reported [12].…”

Section: Introductionmentioning

confidence: 99%

Recent updates and perspectives on leishmaniasis

Savoia

2015

J Infect Dev Ctries

146

128

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Leishmaniasis is a neglected vector-borne tropical infection considered to be a disease of the poor. Concentrated in poverty-stricken countries within Southeast Asia, East Africa, and Latin America, it is also endemic in several Mediterranean countries. The management of the heterogeneous syndromes determined by parasites belonging to the genus Leishmania is particularly difficult in developed, non-endemic countries owing to the unfamiliarity of physicians with clinical symptoms, diagnostic possibilities, and available treatment options. Therefore, travelers and other people who may be exposed to sand flies in endemic areas should receive counseling regarding leishmaniasis and appropriate protective measures. Serological diagnosis is rarely used for cutaneous and mucocutaneous diseases, but it is the most commonly used technique for visceral leishmaniasis. The drugs used to treat this last disease are expensive and sometimes have toxic side effects. This review highlights the diagnostic, chemotherapeutic, and immunizing strategies to control leishmaniasis, though no human vaccine is commercially available currently owing to the complexity of the cellular immune response to this parasite.

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“…[93][94][95][96] Data from HIV/Leishmania-infected individuals using immunological tests and the observations collected in the Mediterranean area showed a relatively low sensitivity. 82 Nevertheless, in coinfected patients in Brazil, sensitivity was not low, showing 77% positivity in serology. 87 Approaches for the detection of the etiological agent have relatively low sensitivity, and different methods do not identify the species of Leishmania.…”

Section: Leishmaniasismentioning

confidence: 99%

“…Concerning VL-HIV coinfection, the typical form, characterized by fever, splenomegaly, and hepatomegaly, is more common. [80][81][82][83] However, atypical manifestations, including the involvement of the gastrointestinal tract and kidneys, have been reported, whereas diarrhea and cough are more prevalent in HIV-VL coinfected patients. 84,85 Regarding TL in HIV-infected patients, there are few reports in the literature.…”

Section: Leishmaniasismentioning

confidence: 99%