title: Treatment Options for Visceral Leishmaniasis and HIV Coinfection.
abstract: Leishmania and HIV coinfection is a major health problem in more than 35 countries worldwide. The impaired immune function of visceral leishmaniasis/HIV-coinfected patients may: (i) favor the reactivation of latent Leishmania infection; (ii) induce a more severe presentation of visceral leishmaniasis; (iii) cause a poorer therapeutic response; and (iv) increase the risk of relapse after treatment. One of the major challenges in the management of visceral leishmaniasis/HIV coinfection is developing an effective drug therapy that not only resolves the first episode of visceral leishmaniasis but also prevents relapse. However, scarce evidence and data are available on the optimal therapy for visceral leishmaniasis/HIV coinfection. In our study we reviewed the efficacy of several drugs currently employed for visceral leishmaniasis in HIV patients and current knowledge of secondary prophylaxis. Additionally, we reviewed a set of ongoing clinical trials that are being performed to evaluate the efficacy of new therapeutic regimens for visceral leishmaniasis in patients with and without HIV. Finally, other therapeutic strategies based on immunotherapy, vaccination, or screening for latent leishmaniasis infection in HIV patients are reviewed. Apart from being potentially useful in clinical practice, the results obtained in our study highlight the need for further research on the management of visceral leishmaniasis/HIV coinfection.
authors.affiliation: Infectious Diseases Department, National Referral Unit for Tropical Diseases, Ramón y Cajal University Hospital, IRICYS, Madrid, Spain.
authors.forename: Begoña
authors.initials: B
authors.lastname: Monge-Maillo
authors.affiliation: Infectious Diseases Department, National Referral Unit for Tropical Diseases, Ramón y Cajal University Hospital, IRICYS, Madrid, Spain.
authors.forename: Rogelio
authors.initials: R
authors.lastname: López-Vélez
mesh_terms: D000666:Amphotericin B / Q000627:therapeutic use; D000967:Antimony Sodium Gluconate / Q000627:therapeutic use; D000981:Antiprotozoal Agents / Q000627:therapeutic use*; D000998:Antiviral Agents / Q000627:therapeutic use*; D060085:Coinfection; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy* / Q000517:prevention & control; D006801:Humans; D007893:Leishmania donovani / Q000187:drug effects*; D007898:Leishmaniasis, Visceral / Q000150:complications / Q000188:drug therapy* / Q000517:prevention & control; D008536:Meglumine / Q000627:therapeutic use; D000077485:Meglumine Antimoniate; D009942:Organometallic Compounds / Q000627:therapeutic use; D010767:Phosphorylcholine / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D000981:Antiprotozoal Agents; D000998:Antiviral Agents; D009942:Organometallic Compounds; C068538:liposomal amphotericin B; D010767:Phosphorylcholine; C039128:miltefosine; D008536:Meglumine; D000077485:Meglumine Antimoniate; D000666:Amphotericin B; D000967:Antimony Sodium Gluconate