Visceral Leishmaniasis and HIV coinfection in East Africa

PLoS Negl Trop Dis. 2014 Jun 26;8(6):e2869. doi: 10.1371/journal.pntd.0002869. eCollection 2014 Jun.

Abstract

Visceral Leishmaniasis (VL) is an important protozoan opportunistic disease in HIV patients in endemic areas. East Africa is second to the Indian subcontinent in the global VL caseload and first in VL-HIV coinfection rate. Because of the alteration in the disease course, the diagnostic challenges, and the poor treatment responses, VL with HIV coinfection has become a very serious challenge in East Africa today. Field experience with the use of liposomal amphotericin B in combination with miltefosine, followed by secondary prophylaxis and antiretroviral drugs, looks promising. However, this needs to be confirmed through clinical trials. Better diagnostic and follow-up methods for relapse and prediction of relapse should also be looked for. Basic research to understand the immunological interaction of the two infections may ultimately help to improve the management of the coinfection.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Africa, Eastern / epidemiology
  • Amphotericin B / therapeutic use
  • Anti-Retroviral Agents / therapeutic use
  • Antiprotozoal Agents / therapeutic use
  • Coinfection / epidemiology*
  • HIV Infections / complications*
  • HIV Infections / drug therapy
  • HIV Infections / epidemiology*
  • Humans
  • Leishmaniasis, Visceral / complications*
  • Leishmaniasis, Visceral / drug therapy
  • Leishmaniasis, Visceral / epidemiology*
  • Phosphorylcholine / analogs & derivatives
  • Phosphorylcholine / therapeutic use
  • Prevalence

Substances

  • Anti-Retroviral Agents
  • Antiprotozoal Agents
  • liposomal amphotericin B
  • Phosphorylcholine
  • miltefosine
  • Amphotericin B

Grant support

ED has received individual PhD scholarship from Belgian development cooperation. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.