Visceral leishmaniasis in HIV-1 -infected individuals

Medrano, F.J.; Hernández-Quero, José; Jiménez, Enrique; Pineda, Juan A; Rivero, Antonio; Sánchez-Quijano, A; Vélez, Iván Darío; Viciana, Pompeyo; Castillo, Rafael; Reyes, María José; Carvajal, Francisco J.; Leal, Manuel; Lissén, E

doi:10.1097/00002030-199212000-00013

Cited by 78 publications

(21 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Amastigotes are demonstrable in peripheral blood smears in more than 60% of co-infected patients, thus confirming the existence of this form of transmission. In addition, these individuals can serve as true reservoirs of the parasite by easily infecting phlebotomine flies feeding on their blood (Medrano et al 1993, Alvar 1994, Alvar et al 1997.…”

Section: Opportunistic Disease Caused By Leishmania Spmentioning

confidence: 99%

Some Aspects of Protozoan Infections in Immunocompromised Patients: A Review

Ferreira

Borges

2002

Mem. Inst. Oswaldo Cruz

192

130

View full text Add to dashboard Cite

Section: Opportunistic Disease Caused By Leishmania Spmentioning

confidence: 99%

Some Aspects of Protozoan Infections in Immunocompromised Patients: A Review

Ferreira

Borges

2002

Mem. Inst. Oswaldo Cruz

192

130

View full text Add to dashboard Cite

“…26 This is more prevalent in advanced HIV-1 disease, as in the heavily immunosuppressed patients reported in this study. 26 Although definitive conclusions cannot be made from the current study, the data suggest that doses exceeding 850 mg/ day are more efficacious than those reported with an upper limit of 850 mg/day, [6][7][8][9]11,12 but this should be tempered by this higher toxicity. It is possible that the efficacy observed in this study is due at least in part to having used allopurinol along with MA since this therapy seems to show greater efficacy than MA alone.…”

Section: Discussionmentioning

confidence: 74%

“…1 Data on the effect of Sb V on HIV-1-infected patients with VL come mostly from retrospective series that describe clinical aspects of the coinfection. [6][7][8][9][10][11][12] However, none of these studies follow the dose recommendations of the CDC 5 with respect to the schedule of treatment with Sb V . Thus, the present study provides information on the effect of Sb V administered at the currently recommended doses to HIV-1-infected patients with VL.…”

Section: Discussionmentioning

confidence: 99%

“…1 Microbiologic cure is observed in less than half the cases and relapses are frequent. [6][7][8][9] In this setting, toxic effects of Sb V have seldom been reported in previous studies. 6,10,11 However, the dose of Sb V used in these patients was limited to a maximum of 850 mg/day.…”

mentioning

confidence: 94%

“…6,10,11 However, the dose of Sb V used in these patients was limited to a maximum of 850 mg/day. [6][7][8][9][10][11][12] Therefore, we assume that a low dose was administered. Thus, few data are available on efficacy and safety of the currently recommended Sb V dosing schedule to treat VL in HIV-1-infected individuals.…”

mentioning

confidence: 99%

See 2 more Smart Citations

High frequency of serious side effects from meglumine antimoniate given without an upper limit dose for the treatment of visceral leishmaniasis in human immunodeficiency virus type-1-infected patients.

Delgado¹,

Macı́as²,

Pineda³

et al. 1999

The American Journal of Tropical Medicine and Hygiene

View full text Add to dashboard Cite

Abstract. Organic pentavalent antimonials are one of the mainstays of treatment for visceral leishmaniasis (VL). Few data are available on the toxicity and efficacy of these drugs at the dosing schedule recommended by the Centers for Disease Control and Prevention (CDC) (Atlanta, GA). We analyzed 25 VL episodes in human immunodeficiency virus (HIV)-infected patients who were treated with meglumine antimoniate (MA) at the CDC-recommended dose in southern Spain. Adverse effects were observed in 14 (56%) VL episodes. In 7 (28%), treatment with MA was permanently discontinued due to serious adverse effects that included acute pancreatitis, acute renal failure, and leukopenia. Three (12%) patients died during therapy due to severe acute pancreatitis attributable to MA. The dosing regimen of MA currently recommended for treating VL is associated with a high rate of serious side effects in HIV-1-infected patients.Visceral leishmaniasis (VL) caused by Leishmania infantum is endemic in countries bordering the Mediterranean basin. It has been increasingly recognized that it affects human immunodeficiency virus type-1 (HIV-1)-infected patients, not only in this endemic area 1 , but also in non-endemic western countries. 2,3 Organic pentavalent antimonials (Sb V ) are one of the first-line drugs recommended by the Word Health Organization (WHO) for treating VL in the Mediterranean area. 4 In 1982, WHO (unpublished data) advocated treatment with 20 mg of Sb V /kg of body weight, with a maximum dose of 850 mg/day. The Centers for Disease Control (CDC) (Atlanta, GA) recommended in 1992 to remove the upper limit dose. 5 Data that supported this recommendation stemmed from clinical trials with patients not infected with HIV. 5 It was reported that higher daily doses without an upper limit resulted in better responses. Side effects were regarded as reversible and rarely severe.Patients with VL coinfected with HIV have a poor response to Sb V therapy. 1 Microbiologic cure is observed in less than half the cases and relapses are frequent. [6][7][8][9] In this setting, toxic effects of Sb V have seldom been reported in previous studies. 6,10,11 However, the dose of Sb V used in these patients was limited to a maximum of 850 mg/day. 6-12 Therefore, we assume that a low dose was administered. Thus, few data are available on efficacy and safety of the currently recommended Sb V dosing schedule to treat VL in HIV-1-infected individuals. 1 We provide herein data on toxicity and efficacy of meglumine antimoniate (MA) at a dose of 20 mg/kg of body weight/day with no dose limit in HIV-1-infected patients with VL. PATIENTS AND METHODSPatients. Fifty-one episodes of VL were diagnosed in 46 HIV-1-infected patients attending 2 University Hospital Acquired Immunodeficiency Syndrome (AIDS) care units in Seville, Spain from October 1993 to December 1997. Based on the diagnosis of the responsible physician, 25 VL episodes (49%) were treated with MA following the dosing schedule recommended by CDC in 1992. 5 Twenty-four were initial episodes and 1 w...

show abstract

Kala-Azar Comes to New York

Parkas

Godwin²,

Murray³

1997

Arch Intern Med

View full text Add to dashboard Cite

Visceral leishmaniasis (kala-azar) is a disseminated protozoal infection that occurs in areas of the world other than North America. In endemic regions, kala-azar is also an opportunistic infection associated with the acquired immunodeficiency syndrome. We report a case of acquired immunodeficiency syndrome-associated kala-azar acquired abroad that was first expressed in New York City. Human immunodeficiency virus-infected patients who have lived or traveled abroad may present in this country with unusual infections.

show abstract

Visceral leishmaniasis in HIV-1 -infected individuals

Cited by 78 publications

References 0 publications

Some Aspects of Protozoan Infections in Immunocompromised Patients: A Review

Some Aspects of Protozoan Infections in Immunocompromised Patients: A Review

High frequency of serious side effects from meglumine antimoniate given without an upper limit dose for the treatment of visceral leishmaniasis in human immunodeficiency virus type-1-infected patients.

Kala-Azar Comes to New York

Contact Info

Product

Resources

About