title: American tegumentary leishmaniasis and HIV-AIDS association in a tertiary care center in the Brazilian Amazon.
abstract: American tegumentary leishmaniasis (ATL) and human immunodeficiency virus (HIV) are both common infectious diseases in the Brazilian Amazon with overlapping expansion areas, which leads to the occurrence of Leishmania/HIV coinfection. Most ATL/HIV-acquired immunodeficiency syndrome (AIDS) association cases have been reported from areas where Leishmania (Viannia) braziliensis is the main pathogen; this finding is in contrast with the Amazon region, where L. (V.) guyanensis is the most implicated agent, implying distinct clinical and therapeutic aspects. We describe 15 cases of ATL/HIV coinfection treated in a tertiary care center in the Brazilian Amazon between 1999 and 2008. Thirteen patients presented with diverse clinical manifestations of cutaneous leishmaniasis, and four of them had disseminated forms; two patients presented with mucosal leishmaniasis (ML). Seven patients required more than one course of treatment. The particularities of ATL/HIV-AIDS association in L. (V.) guyanensis-endemic areas require efforts for an increased understanding of its burden and subsequent improvements in case management.
authors: Gerência de Leishmaniose, Gerência de DST e AIDS, Gerência de Malária, Gerência de Entomologia e Gerência de Dermatologia Tropical, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brazil. jguerra291@gmail.com
authors: Jorge Augusto O
authors: JA
authors: Guerra
authors: Leíla I R C
authors: LI
authors: Coelho
authors: Flávio R
authors: FR
authors: Pereira
authors: André M
authors: AM
authors: Siqueira
authors: Rogério L
authors: RL
authors: Ribeiro
authors: Thiago Miranda L
authors: TM
authors: Almeida
authors: Marcus Vinícius G
authors: MV
authors: Lacerda
authors: Maria das Graças V
authors: Md
authors: Barbosa
authors: Sinésio
authors: S
authors: Talhari
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology*; D000328:Adult; D001938:Brazil / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D016773:Leishmaniasis, Cutaneous / Q000150:complications* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult