Immunochemotherapy for Visceral Leishmaniasis: a Controlled Pilot Trial of Antimony Versus Antimony Plus Interferon-Gamma

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  • Division of Infectious Diseases, Cornell University Medical College, Boehringer Ingelheim, United States Army Medical Research Unit-Kenya, Kenya Medical Research Institute, New York, New York, Germany

Twenty-four Kenyan patients with visceral leishmaniasis were treated for 30 days with either conventional therapy (daily pentavalent antimony, n = 14) or experimental immunochemotherapy (daily antimony plus interferon-gamma [IFN-γ] every other day, n = 10). All 24 patients responded clinically to treatment, and microscopic splenic aspirate scores rapidly decreased in both groups. As judged by splenic aspirate culture results, IFN-γ-treated patients responded more quickly (50% versus 22% culture-negative after one week and 75% versus 58% culture-negative after two weeks). While not statistically significant, these differences raise the possibility that combination therapy using IFN-γ, which was safe and well-tolerated, may accelerate the early parasitologic response in patients with visceral leishmaniasis.