title: Case Report: No Response to Liposomal Daunorubicin in a Patient with Drug-Resistant HIV-Associated Visceral Leishmaniasis.
abstract: Visceral leishmaniasis (VL) in patients with HIV co-infection presents a significant therapeutic challenge due to the lessened chance of achieving long-term cure. We report a case of VL in a 60-year-old man with HIV infection who became refractory to anti-leishmania treatment due to multi-drug resistance. In the face of a worsening clinical situation, and with no other options available, he was treated with an experimental regimen of liposomal daunorubicin, which has previously been shown to have in vitro activity against Leishmania donovani and to be effective treatment of VL in animal studies. To our knowledge, he was the first patient with VL and HIV co-infection to have this treatment evaluated. We report on the lack of response to this treatment and possible causes for its failure.
authors: Department of Infectious Diseases, Auckland City Hospital, Auckland, New Zealand.
authors: Nicholas J
authors: NJ
authors: Gow
authors: Department of Infectious Diseases and Tropical Medicine, Northwick Park Hospital, Harrow, England.
authors: Robert N
authors: RN
authors: Davidson
authors: Pharmacy, Auckland City Hospital, Auckland, New Zealand.
authors: Rob
authors: R
authors: Ticehurst
authors: Department of General Medicine, Hawkes Bay Hospital, Hawkes Bay, New Zealand.
authors: Andrew
authors: A
authors: Burns
authors: Department of Infectious Diseases, Auckland City Hospital, Auckland, New Zealand.
authors: Mark G
authors: MG
authors: Thomas
mesh_terms: D019380:Anti-HIV Agents / Q000008:administration & dosage; D000981:Antiprotozoal Agents / Q000008:administration & dosage*; D060085:Coinfection / Q000188:drug therapy*; D003630:Daunorubicin / Q000008:administration & dosage*; D004351:Drug Resistance; D015658:HIV Infections / Q000188:drug therapy*; D015497:HIV-1 / Q000502:physiology; D006801:Humans; D007893:Leishmania donovani / Q000502:physiology; D007898:Leishmaniasis, Visceral / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D017211:Treatment Failure
chemical_list: D019380:Anti-HIV Agents; D000981:Antiprotozoal Agents; D003630:Daunorubicin