Frequency of visceral leishmaniasis relapses in human immunodeficiency virus-infected patients receiving highly active antiretroviral therapy.
There are contradictory data about whether highly active antiretroviral therapy (HAART) prevents visceral leishmaniasis (VL) relapses in human immunodeficiency virus type 1 (HIV-1)-infected patients. The aim of this study was to assess the frequency of VL relapses in individuals receiving HAART. Thirty-one patients who received HAART after developing VL were included in a retrospective cohort study. Ten of them received secondary chemoprophylaxis and the rest did not. Eight (38%) patients without secondary chemoprophylaxis showed a VL relapse. None of the seven subjects with VL relapses and 6 of 11 without recurrence (P = 0.038), in whom all scheduled data were available, showed an increase of more than 100 CD4+ cells/mm(3) during the follow-up. Patients with relapse showed higher levels of HIV RNA viral load at their last visit (P = 0.047). The frequency of VL relapses in patients receiving HAART is high. Relapses of VL are observed only in individuals with uncontrolled HIV replication and/or poor immunologic responses.
Mira
Jose A
JA
Servicio de Medicina Interna e Unidad de Enfermedades Infecciosas, Hospital Universitario de Valme, Seville, Spain. PEPINESCARTI@ono.com
Corzo
Juan E
JE
Rivero
Antonio
A
Macias
Juan
J
De Leon
Fernando Lozano
FL
Torre-Cisneros
Julian
J
Gomez-Mateos
Jesus
J
Jurado
Rafael
R
Pineda
Juan A
JA
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D007898:Leishmaniasis, Visceral / Q000453:epidemiology* / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D012008:Recurrence