title: Visceral Leishmaniasis/HIV co-infection in northeast Brazil: evaluation of outcome.
abstract: Since the beginning of the HIV burden, Visceral Leishmaniasis (VL)/HIV co-infection has been diagnosed not only in areas where VL is endemic (Latin America, India, Asia, Southern Europe), but also in North America, were it is considered an opportunistic disease. Clinical presentation, diagnostic tests sensitivity and treatment response in this population differs from VL alone.
  
  
  OBJECTIVE
  To evaluate factors related to an unfavorable outcome in patients with VL/HIV diagnosis in a reference center in northeast Brazil.
  
  
  METHODS
  Co-infected patients, diagnosed from 2010 to 2012, were included. Data from medical records were collected until one year after VL treatment completion.
  
  
  RESULTS
  Forty-two HIV-infected patients were included in the study. Anemia, leukopenia, and thrombocytopenia were present in 95%, 70.7%, and 63.4%, respectively. Mean T CD4+ (LTCD4) lymphocyte count was 183 cells/dL. Highly active antiretroviral therapy (HAART) was being used by 54.7% of cases. A favorable outcome was seen in 71.4% of cases. Recurrence of VL occurred in nine patients and deaths were secondary to infectious complications (3/42 patients). Very low LTCD4 count (<100 cells/dL) was the only independent variable associated with an unfavorable outcome in multivariate analysis (p=0.03).
  
  
  CONCLUSIONS
  Low LTCD4 count at presentation was associated with unfavorable outcome in VL/HIV patients.
authors.affiliation: Hospital São José de Doenças Infecciosas, Fortaleza, CE, Brazil; Escola de Medicina, Universidade de Fortaleza (UNIFOR), Fortaleza, CE, Brazil. Electronic address: laratavora@gmail.com.
authors.forename: Lara Gurgel Fernandes
authors.initials: LG
authors.lastname: Távora
authors.affiliation: Escola de Medicina, Universidade de Fortaleza (UNIFOR), Fortaleza, CE, Brazil.
authors.forename: Marina Bizerril
authors.initials: MB
authors.lastname: Nogueira
authors.affiliation: Escola de Medicina, Universidade de Fortaleza (UNIFOR), Fortaleza, CE, Brazil.
authors.forename: Sofia Teixeira
authors.initials: ST
authors.lastname: Gomes
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D001938:Brazil / Q000453:epidemiology; D018791:CD4 Lymphocyte Count; D060085:Coinfection / Q000188:drug therapy* / Q000401:mortality; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D007898:Leishmaniasis, Visceral / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014344:Trypanocidal Agents / Q000627:therapeutic use*
chemical_list: D014344:Trypanocidal Agents
keywords: AIDS; HIV; Visceral Leishmaniasis