title: Leishmaniasis-HIV coinfection: current challenges.
abstract: Leishmaniasis - human immunodeficiency virus (HIV) coinfection can manifest itself as tegumentary or visceral leishmaniasis. Almost 35 countries have reported autochthonous coinfections. Visceral leishmaniasis is more frequently described. However, usual and unusual manifestations of tegumentary leishmaniasis have been reported mainly in the Americas, but the real prevalence ofLeishmaniainfection in HIV-infected patients is not clear. Regarding the clinical manifestations, there are some reports showing unusual manifestations in visceral leishmaniasis and tegumentary leishmaniasis in HIV-infected patients; yet, the usual manifestations are more frequent. Leishmaniasis diagnosis relies on clinical methods, but serological tests are used to diagnose visceral leishmaniasis despite them having a low sensitivity to tegumentary leishmaniasis. The search for the parasite is used to diagnose both visceral leishmaniasis and tegumentary leishmaniasis. Nevertheless, in HIV-infected patients, the sensitivity of serology is very low. Drugs available to treat leishmaniasis are more restricted and cause severe side effects. Furthermore, in HIV-infected patients, these side effects are more prominent and relapses and lethality are more recurrent. In this article, we discuss the current challenges of tegumentary leishmaniasis and visceral leishmaniasis-HIV infection, focusing mainly on the clinical manifestations, diagnosis, and treatment of leishmaniasis.
authors: Laboratory of Soroepidemiology (LIM HC-FMUSP), São Paulo University, São Paulo; Instituto de Infectologia Emilio Ribas-SES, São Paulo.
authors: José Angelo Lauletta
authors: JA
authors: Lindoso
authors: Department of Infectious Disease, Faculty of Medicine, São Paulo University, São Paulo.
authors: Mirella Alves
authors: MA
authors: Cunha
authors: Hospital Giselda Trigueiro - SESAP, Natal, Brazil.
authors: Igor Thiago
authors: IT
authors: Queiroz
authors: Instituto de Infectologia Emilio Ribas-SES, São Paulo.
authors: Carlos Henrique Valente
authors: CH
authors: Moreira
keywords: HIV infection; clinical manifestations; coinfection; diagnosis; epidemiology; leishmaniasis; treatment