title: HIV/AIDS-associated visceral leishmaniasis in patients from an endemic area in Central-west Brazil.
abstract: An increase in morbidity associated with visceral leishmaniasis (VL) in human immunodeficiency virus (HIV)/AIDS patients has been described in Africa and the Mediterranean. Despite the high endemicity of VL and HIV-1/AIDS in Brazil, this association has not been thoroughly investigated. Our aim was to evaluate the epidemiologic and clinical characteristics of VL-HIV-1/AIDS cases from Central-west [Mato Grosso do Sul (MS)] Brazil. Medical records of 23 VL-HIV-1/AIDS patients were reviewed. Patients were predominantly adult males (87%) and 34.8% of the patients were intravenous drug users (IVDU). Leishmaniasis was the first opportunistic infection in 60% of the HIV-1 patients. Fever occurred in all patients, although splenomegaly and hepatomegaly were absent in 21.7% of the cases. CD4+ T-cell counts were below 200 cells/mm(3) in 80% of the cases and the counts did not increase after clinical remission despite antiretroviral therapy. The first drug chosen to treat the cases was antimonial, but the therapeutic regimen was altered to amphotericin B in 12 of 17 cases due to side effects. Relapses were reported in 56.5% of the patients. IVDU may constitute an important risk factor for the transmission of both diseases in MS. VL-HIV-1/AIDS patients in MS share similar clinical characteristics as those from other endemic regions worldwide. Thus, these findings are critical for improving the surveillance of VL-HIV/AIDS patients.
authors.affiliation: Laboratório Interdisciplinar de Pesquisas Médicas, Instituto Oswaldo Cruz-Fiocruz, Rio de Janeiro, Brasil.
authors.forename: Priscilla
authors.initials: P
authors.lastname: Alexandrino-de-Oliveira
authors.forename: Joanna Reis
authors.initials: JR
authors.lastname: Santos-Oliveira
authors.forename: Maria Elizabeth Cavalheiros
authors.initials: ME
authors.lastname: Dorval
authors.forename: Francisco das Chagas Brandão
authors.initials: Fd
authors.lastname: Da-Costa
authors.forename: Gracy Regina Oliveira Leite
authors.initials: GR
authors.lastname: Pereira
authors.forename: Rivaldo Venâncio
authors.initials: RV
authors.lastname: da Cunha
authors.forename: Anamaria Mello Miranda
authors.initials: AM
authors.lastname: Paniago
authors.forename: Alda Maria
authors.initials: AM
authors.lastname: Da-Cruz
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D001938:Brazil; D018791:CD4 Lymphocyte Count; D019353:Endemic Diseases; D005260:Female; D006801:Humans; D007898:Leishmaniasis, Visceral / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D008297:Male; D008536:Meglumine / Q000627:therapeutic use; D000077485:Meglumine Antimoniate; D008875:Middle Aged; D009942:Organometallic Compounds / Q000627:therapeutic use; D012307:Risk Factors; D019562:Viral Load; D055815:Young Adult
chemical_list: D000981:Antiprotozoal Agents; D009942:Organometallic Compounds; D008536:Meglumine; D000077485:Meglumine Antimoniate; D000666:Amphotericin B