Visceral leishmaniasis/human immunodeficiency virus co-infection in India: the focus of two epidemics.
India contributes heavily to the global burden of visceral leishmaniasis (VL, kala-azar) and human immunodeficiency virus (HIV)/AIDS. The prevalence of HIV seropositivity in VL patients at a tertiary care centre in northern India, as observed during a prospective study over a period of 2 years, is presented. Of the 104 cases of VL/post-kala-azar dermal leishmaniasis, six (5.7 %) were found to be HIV positive, compared to 11 (5.5 %) seropositive for HIV of 198 patients with fever due to other causes. Four of the six (67 %) VL/HIV co-infected patients had a chronic/relapsing course, not responding to antileishmanial treatment. A CD4 T-cell count of < 200 mm(-3) was found in four of the five (80 %) co-infected patients in whom the test was done. Although the level of HIV/VL co-infection in the present study was lower than that of Mediterranean countries, there is a trend towards rising co-infection. The VL-endemic states of India have a huge population of migrant labourers, who work in high-HIV-prevalence states. The reported increase in the prevalence of HIV in the VL-endemic, populous states of India is a cause of grave concern, and co-infection may assume epidemic proportions in the coming decade if left unchecked.
Mathur
Purva
P
Division of Parasitology and HIV/Immunology, Department of Microbiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi - 110029, India.
Samantaray
J C
JC
Division of Parasitology and HIV/Immunology, Department of Microbiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi - 110029, India.
Vajpayee
Madhu
M
Division of Parasitology and HIV/Immunology, Department of Microbiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi - 110029, India.
Samanta
Palash
P
Division of Parasitology and HIV/Immunology, Department of Microbiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi - 110029, India.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D005260:Female; D006678:HIV / Q000254:growth & development*; D015483:HIV Antibodies / Q000097:blood; D015658:HIV Infections / Q000453:epidemiology* / Q000469:parasitology* / Q000821:virology; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D007891:Leishmania / Q000254:growth & development*; D007898:Leishmaniasis, Visceral / Q000453:epidemiology* / Q000469:parasitology / Q000821:virology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
D015483:HIV Antibodies