Miltefosine for visceral leishmaniasis relapse treatment and secondary prophylaxis in HIV-infected patients.
Miltefosine is the first effective oral drug against visceral leishmaniasis. However, there are few data about its role against the increasing problem of HIV-associated visceral leishmaniasis. It is necessary to establish a treatment and secondary prophylaxis approach with miltefosine in this population, particularly for those in whom standard treatment was unsuccessful. We report our experience with miltefosine in 5 HIV-infected patients. Miltefosine was used in relapse treatments (50 mg, b.i.d.) in 3 patients and as maintenance therapy (50 mg, 3 times/week) in all of them. Miltefosine was discontinued after full recovery of immune function in 4 patients. The median disease-free period has been 20 months since miltefosine discontinuation. One patient was lost to follow-up. Miltefosine dosage regimens for the treatment of relapses and for maintenance treatment in HIV-infected patients should be established in prospective studies.
Marques
Nuno
N
Infectious Diseases Department, University Hospital of Coimbra, Coimbra, Portugal. lusonmar@hotmail.com
Sá
Rosa
R
Coelho
Filomena
F
Oliveira
Joaquim
J
Saraiva Da Cunha
J
J
Meliço-Silvestre
A
A
D000328:Adult; D000981:Antiprotozoal Agents / Q000627:therapeutic use*; D018890:Chemoprevention / Q000379:methods; D015658:HIV Infections / Q000150:complications / Q000276:immunology; D006801:Humans; D007898:Leishmaniasis, Visceral / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010767:Phosphorylcholine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D055502:Secondary Prevention
D000981:Antiprotozoal Agents; D010767:Phosphorylcholine; C039128:miltefosine