1921
Volume 78, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Sodium stibogluconate has been associated with the reactivation of varicella zoster virus (VZV) in otherwise healthy adults who receive the drug as treatment for cutaneous leishmaniasis. Ten patients receiving daily sodium stibogluconate underwent phlebotomy at baseline and at day 10. Flow cytometry–based immunophenotyping, VZV-specific IgG levels, and lymphocyte proliferative responses and intracellular cytokine secretion to VZV, cytomegalovirus, tetanus toxoid, superantigen, and mitogens were performed at both time points. The absolute number of total leukocytes, total lymphocytes, and lymphocyte subsets decreased overall without predilection for any particular subset of lymphocytes, such that the percentage of the total lymphocyte population for each lymphocyte subset did not change significantly (except for a marginal increase in percentage of cytotoxic T cells). Antibodies to VZV were measured in seven patients before and after treatment, and did not change. Lymphocyte proliferative responses to VZV and other antigens and mitogens did not change from baseline. The mechanism for the increased rate of VZV reactivation after treatment with sodium stibogluconate remains undefined.

Loading

Article metrics loading...

/content/journals/10.4269/ajtmh.2008.78.402
2008-03-01
2017-11-22
Loading full text...

Full text loading...

/deliver/fulltext/14761645/78/3/0780402.html?itemId=/content/journals/10.4269/ajtmh.2008.78.402&mimeType=html&fmt=ahah

References

  1. Piscopo TV, Mallia Azzopardi C, 2007. Leishmaniasis. Postgrad Med J 83 : 649–657.
  2. Shrestha NK, 2006. Sodium stibogluconate. Clin Infect Dis 43 : 1371–1372.
  3. Lawn SD, Armstrong M, Chilton D, Whitty CJ, 2006. Electrocardiographic and biochemical adverse effects of sodium stibogluconate during treatment of cutaneous and mucosal leishmaniasis among returned travelers. Trans R Soc Trop Med Hyg 100 : 264–269.
  4. Franke E, Wignall F, Cruz M, Rosales E, Tovar AA, Lucas CM, Llanos-Cuentas A, Berman JD, 1990. Efficacy and toxicity of sodium stibogluconate for mucosal leishmaniasis. Ann Intern Med 113 : 934–940.
  5. Llanos-Cuentas A, Echevarria J, Cruz M, La Rosa A, Campos P, Campos M, Franke E, Berman J, Modabber E, Marr J, 1997. Efficacy of sodium stibogluconate alone and in combination with allopurinol for treatment of mucocutaneous leishmaniasis. Clin Infect Dis 25 : 677–684.
  6. Davis A, 1968. Comparative trials of antimonial drugs in urinary schistosomiasis. Bull World Health Organ 38 : 197–227.
  7. Wortmann GW, Aronson NE, Byrd JC, Grever MR, Oster CN, 1998. Herpes zoster and lymphopenia associated with sodium stibogluconate therapy for cutaneous leishmaniasis. Clin Infect Dis 27 : 509–512.
  8. Hartzell JD, Aronson NE, Nagaraja S, Whitman T, Hawkes CA, Wortmann G, 2006. Varicella zoster virus meningitis complicating sodium stibogluconate treatment for cutaneous leishmaniasis. Am J Trop Med Hyg 74 : 591–592.
  9. Levin MJ, Smith JG, Kaufhold RM, Barber D, Hayward AR, Chan CY, Chan IS, Li DJ, Wang W, Keller PM, Shaw A, Silber JL, Schlienger K, Chalikonda I, Vessey SJ, Caulfield MJ, 2003. Decline in varicella-zoster virus (VZV)-specific cell-mediated immunity with increasing age and boosting with a high-dose VZV vaccine. J Infect Dis 188 : 1336–1344.
  10. Gilden DH, Cohrs RJ, Mahalingam R, 2003. Clinical and molecular pathogenesis of varicella virus infection. Viral Immun 16 : 243–258.
  11. Klein NP, Holmes TH, Sharp MA, Heineman TC, Schleiss MR, Bernstein DI, Kemble G, Arvin AM, Dekker CL, 2006. Variability and gender differences in memory T cell immunity to varicella-zoster virus in healthy adults. Vaccine 14 : 5913–5918.
  12. Levin MJ, Gershon AA, Weinberg A, Song LY, Fentin T, Nowak B, Pediatric AIDS Clinical Trials Group 265 Team, 2006. Administration of live varicella vaccine to HIV-infected children with current or past significant depression of CD4(+) T cells. J Infect Dis 194 : 247–255.
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.2008.78.402
Loading
/content/journals/10.4269/ajtmh.2008.78.402
Loading

Data & Media loading...

  • Received : 10 Oct 2007
  • Accepted : 04 Jan 2008

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