title: Successful treatment of refractory visceral leishmaniasis in India using antimony plus interferon-gamma.
abstract: Fifteen Indian patients with relapsing or drug-refractory visceral leishmaniasis were retreated for 30 days with antimony plus interferon-gamma (IFN-gamma). All 15 had failure of an initial course of antimony and at least one additional course of antimony or pentamidine; 7 patients had failure of three or four prior courses of therapy. During the study, treatment was discontinued in 2 patients because of anemia and congestive heart failure in 1 and intractable vomiting in the other; both subsequently died. In the remaining 13 patients, IFN-gamma plus antimony treatment was associated with daily fever but no other adverse reactions. After 30 days of therapy, 9 (69%) of the 13 patients were apparently cured. Six months after treatment, all 9 were healthy, had parasite-free bone marrow aspirate smears, and were considered cured. None have relapsed during a mean follow-up of 15.9 +/- 1.7 months. These results support the use of antimony plus IFN-gamma as an immunochemotherapeutic alternative for kala-azar patients who have repeated failures of conventional treatment.
authors.affiliation: Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
authors.forename: S
authors.initials: S
authors.lastname: Sundar
authors.forename: F
authors.initials: F
authors.lastname: Rosenkaimer
authors.forename: H W
authors.initials: HW
authors.lastname: Murray
mesh_terms: D000293:Adolescent; D000328:Adult; D000967:Antimony Sodium Gluconate / Q000627:therapeutic use*; D002648:Child; D003131:Combined Modality Therapy; D003643:Death; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007194:India; D007371:Interferon-gamma / Q000627:therapeutic use*; D007898:Leishmaniasis, Visceral / Q000628:therapy*; D008297:Male; D010419:Pentamidine / Q000627:therapeutic use; D011994:Recombinant Proteins; D013997:Time Factors
chemical_list: D011994:Recombinant Proteins; D010419:Pentamidine; D007371:Interferon-gamma; D000967:Antimony Sodium Gluconate