Treatment of visceral leishmaniasis: a review of current treatment practices.
Visceral leishmaniasis (VL) is a systemic protozoan infection that infects a million people living in subtropical and tropical areas. Once established, the clinical course of untreated disease leads to death. Recent, large-scale epidemics in east Africa and India and the emergence of a new epidemic in patients infected with HIV makes VL a priority for the World Health Organization. Pentavalent antimonials have been the mainstay of the treatment for > 60years. The progressive appearance of antimonial resistance, the developments of lipid formulations of amphotericin B and a new oral administered drug (miltefosine) have changed the pattern of VL treatment. The prohibitive cost of new therapies leads to different treatment practices according to the socioeconomic and cultural status of each region.
Marty
Pierre
P
Groupe de Recherche en Immunopathologie de la Leishmaniose, Faculté de Médecine, Université de Nice-Sophia-Antipolis et Service de Parasitologie-Mycologie, Centre Hospitalier Universitaire de Nice, Hôpital de l'Archet, Nice, France. marty@unice.fr
Rosenthal
Eric
E
D000666:Amphotericin B / Q000627:therapeutic use; D000818:Animals; D000981:Antiprotozoal Agents / Q000009:adverse effects / Q000627:therapeutic use*; D003906:Developing Countries; D015658:HIV Infections / Q000150:complications; D006801:Humans; D007898:Leishmaniasis, Visceral / Q000188:drug therapy* / Q000453:epidemiology / Q000276:immunology; D051379:Mice; D010767:Phosphorylcholine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D014944:World Health Organization
D000981:Antiprotozoal Agents; D010767:Phosphorylcholine; C039128:miltefosine; D000666:Amphotericin B