title: Liposomal amphotericin B for the treatment of visceral leishmaniasis.
abstract: During the past decade, liposomal amphotericin B has been used with increasing frequency to treat visceral leishmaniasis (VL). The World Health Organization convened a workshop to review current knowledge and to develop guidelines for liposomal amphotericin B use for VL. In Europe, liposomal amphotericin B is widely used to treat VL. In Africa and Asia, the VL disease burden is high and drug access is poor; liposomal amphotericin B is available only through preferential pricing for nonprofit groups in East Africa. Clinical trials and experience demonstrate high efficacy and low toxicity for liposomal amphotericin B (total dose, 20 mg/kg) in immunocompetent patients with VL. Combination trials in areas with antileishmanial drug resistance, and treatment and secondary prophylaxis trials in VL-human immunodeficiency virus-coinfected patients, are important to safeguard the current armamentarium and to optimize regimens. The public health community should work to broaden access to preferential liposomal amphotericin B pricing by public sector VL treatment programs.
authors.affiliation: Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: Caryn
authors.initials: C
authors.lastname: Bern
authors.forename: Jill
authors.initials: J
authors.lastname: Adler-Moore
authors.forename: Juan
authors.initials: J
authors.lastname: Berenguer
authors.forename: Marleen
authors.initials: M
authors.lastname: Boelaert
authors.forename: Margriet
authors.initials: M
authors.lastname: den Boer
authors.forename: Robert N
authors.initials: RN
authors.lastname: Davidson
authors.forename: Concepcion
authors.initials: C
authors.lastname: Figueras
authors.forename: Luigi
authors.initials: L
authors.lastname: Gradoni
authors.forename: Dimitris A
authors.initials: DA
authors.lastname: Kafetzis
authors.forename: Koert
authors.initials: K
authors.lastname: Ritmeijer
authors.forename: Eric
authors.initials: E
authors.lastname: Rosenthal
authors.forename: Catherine
authors.initials: C
authors.lastname: Royce
authors.forename: Rosario
authors.initials: R
authors.lastname: Russo
authors.forename: Shyam
authors.initials: S
authors.lastname: Sundar
authors.forename: Jorge
authors.initials: J
authors.lastname: Alvar
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000517:prevention & control; D000666:Amphotericin B / Q000008:administration & dosage / Q000191:economics / Q000493:pharmacokinetics / Q000627:therapeutic use*; D000818:Animals; D000981:Antiprotozoal Agents / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D004337:Drug Carriers; D016527:Drug Costs; D006287:Health Planning Guidelines; D006801:Humans; D007898:Leishmaniasis, Visceral / Q000188:drug therapy*; D008081:Liposomes; D016896:Treatment Outcome
chemical_list: D000981:Antiprotozoal Agents; D004337:Drug Carriers; D008081:Liposomes; C068538:liposomal amphotericin B; D000666:Amphotericin B