Visceral leishmaniasis recrudescence in a patient with AIDS

Antúnes, Francisco; Carvalho, Celia; Tavares, Luís; Botas, J; Forte, Miguel; Rio, Ana Maria del; Dutschmann, L; Costa, A.; Abranches, P.; Pereira, Conceição Silva; Paiva, Jose Eduardo David; Araujo, Fernando Carvalho; Baptista, António M.

doi:10.1016/0035-9203(87)90419-6

Cited by 14 publications

(2 citation statements)

References 2 publications

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“…An HIV-seropositive patient with visceral leishmaniosis was further diagnosed with cerebral toxoplasmosis by the presence of IgG antibodies to T. gondii (dye and agglutination tests) and clinical and computer tomography (CT) scan features (Antunes et al . 1987). The patient's condition improved after pyrimethamine and sulphadiazine therapy for toxoplasmosis and antimony for leishmaniosis.…”

Section: Toxoplasmosis In Humansmentioning

confidence: 99%

Epidemiological review ofToxoplasma gondiiinfection in humans and animals in Portugal

et al. 2014

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Toxoplasmosis is a worldwide zoonosis. However, data from Portugal are limited and a considerable part of the literature is in Portuguese. Currently, the rate of congenital infection in Portugal is unknown, and almost nothing is known of sequelae of congenital toxoplasmosis. There is no recent general population-based serological survey of Toxoplasma gondii in humans in Portugal. In addition, there is little information on genetic characteristics of T. gondii in animals and humans. In the present paper, we review prevalence, clinical spectrum and epidemiology of T. gondii in humans and animals in Portugal. This knowledge should be useful to biologists, public health workers, physicians and veterinarians.

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Section: Toxoplasmosis In Humansmentioning

confidence: 99%

Epidemiological review ofToxoplasma gondiiinfection in humans and animals in Portugal

et al. 2014

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“…HIV-positive patients with VL have very frequent recurrences, probably due to the reactivation of the process caused by the inability of the immune system to help control the infection. Recurrences of VL can be treated de novo with Sb V (10,20,243), for which reason an increase in the treatment time has been suggested. Nevertheless, the efficiency of this drug can decrease (81,113), perhaps because the parasite develops resistance to the drug (16,165).…”

Section: Treatment Of Relapsesmentioning

confidence: 99%

Leishmania and human immunodeficiency virus coinfection: the first 10 years

et al. 1997

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Over 850 Leishmania-human immunodeficiency virus (HIV) coinfection cases have been recorded, the majority in Europe, where 7 to 17% of HIV-positive individuals with fever have amastigotes, suggesting that Leishmania-infected individuals without symptoms will express symptoms of leishmaniasis if they become immunosuppressed. However, there are indirect reasons and statistical data demonstrating that intravenous drug addiction plays a specific role in Leishmania infantum transmission: an anthroponotic cycle complementary to the zoonotic one has been suggested. Due to anergy in patients with coinfection, L. infantum dermotropic zymodemes are isolated from patient viscera and a higher L. infantum phenotypic variability is seen. Moreover, insect trypanosomatids that are currently considered nonpathogenic have been isolated from coinfected patients. HIV infection and Leishmania infection each induce important analogous immunological changes whose effects are multiplied if they occur concomitantly, such as a Th1-to-Th2 response switch; however, the consequences of the viral infection predominate. In fact, a large proportion of coinfected patients have no detectable anti-Leishmania antibodies. The microorganisms share target cells, and it has been demonstrated in vitro how L. infantum induces the expression of latent HIV-1. Bone marrow culture is the most useful diagnostic technique, but it is invasive. Blood smears and culture are good alternatives. PCR, xenodiagnosis, and circulating-antigen detection are available only in specialized laboratories. The relationship with low levels of CD4+ cells conditions the clinical presentation and evolution of disease. Most patients have visceral leishmaniasis, but asymptomatic, cutaneous, mucocutaneous, diffuse cutaneous, and post-kala-azar dermal leishmaniasis can be produced by L. infantum. The digestive and respiratory tracts are frequently parasitized. The course of coinfection is marked by a high relapse rate. There is a lack of randomized prospective treatment trials; therefore, coinfected patients are treated by conventional regimens. Prophylactic therapy is suggested to be helpful in preventing relapses.

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Role of T cell subsets during the recall of immunologic memory to Leishmania major

Müller

1992

Eur J Immunol

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The contributions of different T cell subpopulations to the maintenance of immunity during secondary Leishmania major infections were analyzed in healed, resistant animals by depletion of T cell subsets in vivo. The strong delayed-type hypersensitivity mounted in immune genetically resistant mice upon challenge with viable promastigotes was mediated by both CD4+ and CD8+ T cells. Each T cell subpopulation alone contributes, although to a different extent, to the resolution of secondary lesions; both subsets, however, are required for an efficient and rapid healing of the secondary lesions and the decrease in the parasite burden in infected tissues. The results indicate that in immune, genetically resistant CBA mice, the activity of both T cell subsets is required for successful resistance to reinfection and an efficient maintenance of immunity.

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Visceral leishmaniasis recrudescence in a patient with AIDS

Cited by 14 publications

References 2 publications

Epidemiological review ofToxoplasma gondiiinfection in humans and animals in Portugal

Epidemiological review ofToxoplasma gondiiinfection in humans and animals in Portugal

Leishmania and human immunodeficiency virus coinfection: the first 10 years

Role of T cell subsets during the recall of immunologic memory to Leishmania major

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