1921
Volume 70, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

There are contradictory data about whether highly active antiretroviral therapy (HAART) prevents visceral leishmaniasis (VL) relapses in human immunodeficiency virus type 1 (HIV-1)-infected patients. The aim of this study was to assess the frequency of VL relapses in individuals receiving HAART. Thirty-one patients who received HAART after developing VL were included in a retrospective cohort study. Ten of them received secondary chemoprophylaxis and the rest did not. Eight (38%) patients without secondary chemoprophylaxis showed a VL relapse. None of the seven subjects with VL relapses and 6 of 11 without recurrence ( = 0.038), in whom all scheduled data were available, showed an increase of more than 100 CD4+ cells/mm during the follow-up. Patients with relapse showed higher levels of HIV RNA viral load at their last visit ( = 0.047). The frequency of VL relapses in patients receiving HAART is high. Relapses of VL are observed only in individuals with uncontrolled HIV replication and/or poor immunologic responses.

Loading

Article metrics loading...

/content/journals/10.4269/ajtmh.2004.70.298
2004-03-01
2017-11-25
Loading full text...

Full text loading...

/deliver/fulltext/14761645/70/3/0700298.html?itemId=/content/journals/10.4269/ajtmh.2004.70.298&mimeType=html&fmt=ahah

References

  1. Pineda JA, Gallardo JA, Macías J, Delgado J, Regordán C, Morillas F, Relimpio F, Martín-Sánchez J, Sánchez-Quijano A, Leal M, Lissen E, 1998. Prevalence of and factors associated with visceral leishmaniasis in human immunodeficiency virus type 1-infected patients in southern Spain. J Clin Microbiol 36 : 2419–2422.
  2. Alvar J, Cañavete C, Gutiérrez-Solar B, Jiménez M, Laguna F, López-Vélez R, Molina R, Moreno F, 1997. Leishmania and human immunodeficiency virus coinfection: the first 10 years. Clin Microbiol Rev 10 : 298–319.
  3. Gradoni L, Scalone A, Gramiccia M, Troiani M, 1996. Epidemiological surveillance of leishmaniasis in HIV-1 infected individuals in Italy. AIDS 10 : 785–791.
  4. Delgado J, Pineda JA, Gallardo JA, Leal M, Macías J, Sánchez-Quijano A, Lissen E, 1998. Influencia de la actuación médica sobre la forma de presentación del sida definido por episodios clínicos. Med Clin (Barc) 110 : 125–127.
  5. Laguna F, López-Vélez R, Pulido F, Salas A, Torre-Cisneros J, Torre E, Medrano FJ, Sanz J, Pico G, Gómez-Rodrigo J, Pasquau J, Alvar J, 1999. Treatment of visceral leishmaniasis in HIV-infected patients: a randomized trial comparing meglumine antimoniate with amphotericin B. AIDS 13 : 1063–1069.
  6. Palella FJ Jr, Delaney KM, Moorman AC, Loveless MO, Fuhrer J, Satten GA, Aschman DJ, Holmberg SD, 1998. Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. N Engl J Med 338 : 853–860.
  7. Kaplan JE, Hanson D, Dworkin MS, Frederick T, Bertolli J, Lindegren ML, Holmberg S, Jones JL, 2000. Epidemiology of human immunodeficiency virus-associated opportunistic infections in the United States in the era of highly active antiretroviral therapy. Clin Infect Dis 30 : S5–S14.
  8. de la Rosa R, Pineda JA, Delgado J, Macías J, Morillas F, Mira JA, Sánchez-Quijano A, Leal M, Lissen E, 2002. 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. J Clin Microbiol 40 : 762–767.
  9. Berenguer J, Cosín J, Miralles P, López J, Padilla B, 2000. Discontinuation of anti-Leishmania prophylaxis in HIV-infected patients who have responded to highly active antiretroviral therapy. AIDS 14 : 2946–2948.
  10. de la Rosa R, Pineda JA, Delgado J, Macías J, Morillas F, Martín-Sánchez J, Leal M, Sánchez-Quijano A, Lissen E, 2001. Influence of highly active antiretroviral therapy on the outcome of subclinical visceral leishmaniasis in human immunodeficiency virus-infected patients. Clin Infect Dis 32 : 633–635.
  11. Casado JL, López-Velez R, Pintado V, Quereda C, Antela A, Moreno S, 2001. Relapsing visceral leishmaniasis in HIV-infected patients undergoing successful protease inhibitor therapy. Eur J Clin Microbiol Infect Dis 20 : 202–205.
  12. Villanueva JL, Alarcón A, Bernabeu-Wittel M, Cordero E, Prados D, Regordán C, Alvar J, 2000. Prospective evaluation and follow-up of European patients with visceral leishmaniasis and HIV-1 coinfection in the era of the highly active antiretroviral therapy. Eur J Clin Microbiol Infect Dis 19 : 798–801.
  13. Tortajada C, Pérez-Cuevas B, Moreno A, Martínez E, Mallolas J, García F, Valls E, Miró JM, De Lazzari E, Gatell JM, 2002. Highly active antiretroviral therapy (HAART) modifies the incidence and outcome of visceral leishmaniasis in HIV-infected patients (letter). J Acquir Immune Defic Syndr 30 : 364–366.
  14. Pineda JA, Macías J, Morillas F, Fernández-Ochoa J, Cara J, de la Rosa R, Mira JA, Martín-Sánchez J, González M, Delgado J, Acedo C, Lissen E, 2001. Evidence of increased risk for Leishmania infantum infection among HIV-seronegative intravenous drug users from southern Spain. Eur J Clin Microbiol Infect Dis 20 : 354–357.
  15. Morales MA, Cruz I, Rubio JM, Chicharro C, Canavete C, Laguna I, Alvar J, 2002. Relapses versus reinfections in patients coinfected with Leishmania infantum and human immunodeficiency virus type 1. J Infect Dis 185 : 1533–1537.
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.2004.70.298
Loading
/content/journals/10.4269/ajtmh.2004.70.298
Loading

Data & Media loading...

  • Received : 09 Apr 2003
  • Accepted : 26 Nov 2003

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error