title: Miltefosine for visceral leishmaniasis relapse treatment and secondary prophylaxis in HIV-infected patients.
abstract: 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.
authors.affiliation: Infectious Diseases Department, University Hospital of Coimbra, Coimbra, Portugal. lusonmar@hotmail.com
authors.forename: Nuno
authors.initials: N
authors.lastname: Marques
authors.forename: Rosa
authors.initials: R
authors.lastname: Sá
authors.forename: Filomena
authors.initials: F
authors.lastname: Coelho
authors.forename: Joaquim
authors.initials: J
authors.lastname: Oliveira
authors.forename: J
authors.initials: J
authors.lastname: Saraiva Da Cunha
authors.forename: A
authors.initials: A
authors.lastname: Meliço-Silvestre
mesh_terms: 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
chemical_list: D000981:Antiprotozoal Agents; D010767:Phosphorylcholine; C039128:miltefosine