Quantification of the response to miltefosine treatment for visceral leishmaniasis by QT-NASBA.
A male patient with psoriatic arthritis and visceral Leishmania infantum infection was treated with oral miltefosine 50 mg three times a day for 4 weeks at the Academic Medical Center, Amsterdam, The Netherlands. Miltefosine plasma concentrations were measured with liquid chromatography/mass spectrometry. The parasite load was followed by quantitative nucleic acid sequence-based amplification (QT-NASBA) assay in blood. Miltefosine elicited a prompt therapeutic effect. After an initial worsening of symptoms and an increase of QT-NASBA values during the first week, recovery was rapidly achieved. QT-NASBA values declined exponentially and were negative after 6 weeks. Miltefosine plasma concentrations continued to accumulate during the 4 weeks of treatment. The terminal elimination half-life was 14.8 days.
de Vries
P J
PJ
Academic Medical Center, Division of Infectious Diseases, Tropical Medicine & AIDS, Meibergdreef 9, Amsterdam, The Netherlands. p.j.devries@amc.uva.nl
van der Meide
W F
WF
Godfried
M H
MH
Schallig
H D F H
HD
Dinant
H J
HJ
Faber
W R
WR