[Liposomal amphotericin B in secondary prophylaxis of visceral leishmaniasis in HIV-infected patients: report of five clinical cases]

Pathol Biol (Paris). 2004 Mar;52(2):66-75. doi: 10.1016/j.patbio.2003.09.012.
[Article in French]


Treatment of visceral leishmaniasis in HIV patients encounters inefficacy and relapse due to drug resistance, toxicity and immunodepression. Our goal was to evaluate treatment of these patients by liposomal amphotericin B (L-AmB). Since 1998, five clinical files were exploitable out of 13 patients. Protocols used bolus doses ranging between 2.9 and 4.1 mg/kg dispatched on 5-24 days, followed by maintenance dose ranging from 2.7 to 3.8 mg/kg every 15 days. Attack treatment involved high bolus dose (cumulated doses ranging from 60 to 86 mg/kg at day 30) and allowed favorable clinical and biological results with healing in four patients. Secondary prophylaxis with L-AmB has been efficacious and well tolerated in three patients. Although literature and study results cannot indicate a standard therapeutic care in these patients, an initial treatment by L-AmB at doses higher than marketing-approved doses with a secondary prophylaxis by L-AmB associated with an antiretroviral treatment seem to be major asset in order to obtain healing. Expanding this study to a multicenter trial should allow to better define the frequency and duration of the secondary prophylaxis and to evaluate the risk of therapeutic escape as well as the life-span increase.

Publication types

  • Review

MeSH terms

  • Adult
  • Amphotericin B / therapeutic use*
  • Animals
  • Antiprotozoal Agents / therapeutic use*
  • Drug Combinations
  • Drug Evaluation
  • Female
  • HIV Infections / complications*
  • Humans
  • Leishmania infantum
  • Leishmaniasis, Visceral / complications
  • Leishmaniasis, Visceral / drug therapy*
  • Male
  • Meglumine / therapeutic use
  • Meglumine Antimoniate
  • Organometallic Compounds / therapeutic use
  • Phosphatidylcholines / therapeutic use
  • Phosphatidylglycerols / therapeutic use
  • Recurrence
  • Retrospective Studies
  • Substance Abuse, Intravenous / complications
  • Treatment Outcome


  • Antiprotozoal Agents
  • Drug Combinations
  • Organometallic Compounds
  • Phosphatidylcholines
  • Phosphatidylglycerols
  • liposomal amphotericin B
  • Meglumine
  • Meglumine Antimoniate
  • Amphotericin B