1921
Volume 71, Issue 6
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

In 2004, visceral leishmaniasis (kala-azar) maintains its status as a neglected, if not “most neglected” disease. Lack of affordable new drugs, still a basic unsolved problem, has also been joined by additional therapeutic obstacles including large-scale resistance to pentavalent antimony (Sb) in India and coinfection with human immuno-deficiency virus in all endemic regions. Nevertheless, available treatment options have actually expanded because the energetic clinical trials effort of the past decade has yielded tangible advances. This progress includes successful application of less expensive generic Sb; rediscovery of the high-level efficacy of amphotericin B; implementation of short-course parenteral regimens (lipid formulations of amphotericin B); potential to replace Sb and amphotericin B with price-capped paromyomycin; and identification of the first effective oral agent (miltefosine). How to sustain and move this progress ahead, make new advances practical (e.g., affordable, and therefore, deployable), and how to translate promising experimental approaches into actual therapy remain difficult next steps in the treatment of kala-azar.

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References

  1. Yamey G, 2002. The world’s most neglected diseases. BMJ 325 : 176–177. [Google Scholar]
  2. Guerin PJ, Olliaro P, Sundar S, Boelaert M, Croft SL, Desjeux P, Wasunna MK, Bryceson ADM, 2002. Visceral leishmaniasis: current status of control, diagnosis, and treatment, and a proposed research and development agenda. Lancet Infect Dis 2 : 494–501. [Google Scholar]
  3. Murray HW, 2002. Kala-azar - progress against a neglected disease. N Engl J Med 347 : 1793–1794. [Google Scholar]
  4. Murray HW, 2004. Progress in treatment of a neglected disease: visceral leishmaniasis. Expert Rev Anti-Infect Ther 2 : 279–292. [Google Scholar]
  5. Murray HW, 2001. Clinical and experimental advances in treatment in visceral leishmaniasis. Antimicrob Agents Chemother 45 : 2185–2197. [Google Scholar]
  6. Sundar S, More DK, Singh MK, Singh VP, Sharma S, Makharia A, Kumar PCK, Murray HW, 2000. Failure of pentavalent antimony in visceral leishmaniasis in India: report from the center of the Indian epidemic. Clin Infect Dis 31 : 1104–1106. [Google Scholar]
  7. Gradoni L, Bryceson A, Desjeux P, 1995. Treatment of Mediterranean visceral leishmaniasis. Bull World Health Organ 73 : 191–197. [Google Scholar]
  8. Gradoni L, Gramiccia M, Scalone A, 2003. Visceral leishmaniasis treatment, Italy. Emerg Infect Dis 9 : 1617–1620. [Google Scholar]
  9. Veeken H, Ritmeijer K, Seaman J, Davidson R, 2002. A randomized comparison of branded sodium stibogluconate and generic sodium stibogluconate for visceral leishmaniasis under field conditions in Sudan. Trop Med Int Health 5 : 312–317. [Google Scholar]
  10. Thakur CP, Singh RK, Hassan SM, Kumar R, Narain S, Kumar A, 1999. Amphotericin B deoxycholate treatment of visceral leishmaniasis with newer modes of administration and precautions: a study of 938 cases. Trans R Soc Trop Med Hyg 93 : 319–323. [Google Scholar]
  11. Sundar S, Mehta H, Sures AV, Singh SP, Rai M, Murray HW, 2004. Amphotericin B treatment for Indian visceral leishmaniasis: conventional vs. lipid-formulations. Clin Infect Dis 38 : 377–383. [Google Scholar]
  12. Berman JD, Badaro R, Thakur CP, Wasunna KM, Behbehani K, Davidson R, Kuzoe F, Pang L, Weerasuriya K, Bryceson ADM, 1998. Efficacy and safety of liposomal amphotericin B (AmBisome) for visceral leishmaniasis in endemic developing countries. Bull World Health Organ 76 : 25–32. [Google Scholar]
  13. Dietze R, Fagundes S, Brito E, Milan EP, Feitosa TF, Suassuna FAB, Fonschiffrey G, Ksionski G, Dember J, 1995. Treatment of kala-azar in Brazil with Amphocil (amphotericin B cholesterol dispersion) for 5 days. Trans R Soc Trop Med Hyg 89 : 309–311. [Google Scholar]
  14. Gaeta GB, Maisto A, Di Caprio D, Scalone A, Pasquale G, Felaco FM, Galante D, Gradoni L, 2000. Efficacy of amphotericin B colloidal dispersion in the treatment of Mediterranean visceral leishmaniasis in immunocompetent adult patients. Scand J Infect Dis 32 : 675–677. [Google Scholar]
  15. Sundar S, Jha TK, Thakur CP, Mishra M, Singh VP, Buffels R, 2002. Low-dose liposomal amphotericin B in refractory Indian visceral leishmaniasis: a multicenter study. Am J Trop Med Hyg 66 : 143–146. [Google Scholar]
  16. Sundar S, Agrawal G, Rai M, Makharia MK, Murray HW, 2001. Treatment of Indian visceral leishmaniasis with single or daily infusions of low dose liposomal amphotericin B: randomized trial. BMJ 323 : 419–422. [Google Scholar]
  17. Sundar S, Jha TK, Thakur CP, Mishra M, Singh VP, Buffels R, 2003. Single-dose liposomal amphotericin B in the treatment of visceral leishmaniasis in India: a multicenter study. Clin Infect Dis 37 : 800–804. [Google Scholar]
  18. Syriopoulou V, Daikos GL, Theodoridou M, Pavlopoulou I, Manolaki AG, Sereti E, Karamboula A, Papathanasiou D, Krikos X, Saroglou G, 2003. Two doses of a lipid formulation of amphotericin B for the treatment of Mediterranean visceral leishmaniasis. Clin Infect Dis 36 : 560–566. [Google Scholar]
  19. Jha TK, Olliaro P, Thakur CP, Kanyok TP, Singhania BL, Singh IJ, Singh NKP, Akhoury S, Jha S, 1998. Randomised controlled trial of aminosidine (paromomycin) v. sodium stibogluconate for treating visceral leishmaniasis in North Bihar, India. BMJ 61 : 1200–1205. [Google Scholar]
  20. Sundar S, Jha TK, Thakur CP, Engel J, Sindermann H, Fischer C, Junge K, Bryceson A, Berman J, 2002. Oral miltefosine for Indian visceral leishmaniasis. N Engl J Med 347 : 1739–1746. [Google Scholar]
  21. Pagliano P, Rossi M, Rescigno C, Altieri S, Coppola MG, Gramiccia M, Scalone A, Gradoni L, Faella F, 2003. Mediterranean visceral leishmaniasis in HIV-negative adults: a retrospective analysis of 64 consecutive cases (1995–2001). J Antimicrob Chemother 52 : 264–268. [Google Scholar]
  22. Pintado V, Martin-Rabadan P, Rivera ML, Morneo S, Bouza E, 2001. Visceral leishmaniasis in human immunodeficiency virus (HIV)-infected and non-HIV-infected patients. A comparative study. Medicine (Baltimore) 80 : 54–73. [Google Scholar]
  23. Laguna F, 2003. Treatment of leishmaniasis in HIV-positive patients. Ann Trop Med Parasitol 97 (suppl 1): 135–142. [Google Scholar]
  24. Ritmeijer K, Veeken H, Melaku Y, Leal G, Amsalu R, Seaman J, Davidson RN, 2001. Ethiopian visceral leishmaniasis: generic and proprietary sodium stibogluconate are equivalent; HIV co-infected patients have a poor outcome. Trans R Soc Trop Med Hyg 95 : 668–672. [Google Scholar]
  25. Badaro R, Nascimento C, Carvalho JS, Badaro F, Russo D, Ho JL, Reed SG, Jones TC, 1994. Recombinant human granulocyte-macrophage colony-stimulating factor reverses neutropenia and reduces secondary infections in visceral leishmaniasis. J Infect Dis 170 : 413–418. [Google Scholar]
  26. Croft SL, Coombs GH, 2003. Leishmaniasis - current chemotherapy and recent advances in the search for novel drugs. Trends Parasitol 19 : 502–508. [Google Scholar]
  27. Demicheli C, Ochoa R, da Silva JB, Falcao CA, Rossi-Bergmann B, de Melo AL, Sinisterra RD, Frezard F, 2004. Oral delivery of meglumine antimonoate-beta-cyclodextrin complex for treatment of leishmaniasis. Antimicrob Agents Chemother 48 : 100–103. [Google Scholar]
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  • Received : 20 May 2004
  • Accepted : 26 May 2004

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