title: Visceral Leishmaniasis and HIV coinfection in East Africa.
abstract: Visceral Leishmaniasis (VL) is an important protozoan opportunistic disease in HIV patients in endemic areas. East Africa is second to the Indian subcontinent in the global VL caseload and first in VL-HIV coinfection rate. Because of the alteration in the disease course, the diagnostic challenges, and the poor treatment responses, VL with HIV coinfection has become a very serious challenge in East Africa today. Field experience with the use of liposomal amphotericin B in combination with miltefosine, followed by secondary prophylaxis and antiretroviral drugs, looks promising. However, this needs to be confirmed through clinical trials. Better diagnostic and follow-up methods for relapse and prediction of relapse should also be looked for. Basic research to understand the immunological interaction of the two infections may ultimately help to improve the management of the coinfection.
authors: Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium; Department of Internal Medicine, University of Gondar, Gondar, Ethiopia.
authors: Ermias
authors: E
authors: Diro
authors: Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
authors: Lutgarde
authors: L
authors: Lynen
authors: Public Health Department, Médecins Sans Frontières, Amsterdam, the Netherlands.
authors: Koert
authors: K
authors: Ritmeijer
authors: Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.
authors: Marleen
authors: M
authors: Boelaert
authors: School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia.
authors: Asrat
authors: A
authors: Hailu
authors: Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
authors: Johan
authors: J
authors: van Griensven
mesh_terms: D000351:Africa, Eastern / Q000453:epidemiology; D000666:Amphotericin B / Q000627:therapeutic use; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D060085:Coinfection / Q000453:epidemiology*; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D007898:Leishmaniasis, Visceral / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology*; D010767:Phosphorylcholine / Q000031:analogs & derivatives / Q000627:therapeutic use; D015995:Prevalence
chemical_list: D044966:Anti-Retroviral Agents; D000981:Antiprotozoal Agents; C068538:liposomal amphotericin B; D010767:Phosphorylcholine; C039128:miltefosine; D000666:Amphotericin B