Is Visceral Leishmaniasis the same in HIV-coinfected adults?

Abstract

Clinical and laboratory presentation of Visceral Leishmaniasis in HIV-coinfected patients may differ from classic kala-azar, and these differences may be, in part, responsible for the delay in diagnosing and treating leishmaniasis, which might lead to worse outcomes.

Epidemiology of human visceral leishmaniasis in the urban centers of the lower-middle São Francisco Valley, Brazilian semiarid region

“…The clinical presentation of VL in the presence of HIV infection may be atypical; for example, the classical triad (fever, constitutional symptoms and splenomegaly), as well as jaundice and edema, is less frequently observed 25 . Accordingly, the diagnosis of VL is more difficult in individuals with HIV.…”

General aspects of visceral leishmaniasis with or without HIV co-infection in Northeast Brazil

“…In their study, fever was 250 observed more frequently in patients with VL than those with VL/HIV co-infection, [23,28]. Different 254 from many Brazilian studies, which reported the presence of splenomegaly followed by 255 fever, weight loss, and asthenia, in 81 patients with VL/HIV co-infection in Ceará [29] 256 and another study that identified weight loss, weakness, fever, and hepatosplenomegaly 257 as the most common physical changes in 65 patients with VL/HIV co-infection [13], the 258 most common symptoms in this study were skin pallor, hepatomegaly, and levels observed in some patients with VL/HIV co-infection [33,34,35] was also found in 279 the present study. However, we should note that such an increase was higher in patients 280 with VL alone, as additionally reported by De Souza et al and Cota et al [25,36].…”

Opportunist Coinfections by Nontuberculous Mycobacteria and Fungi in Immunocompromised Patients

“…HIV infection is also strongly associated with a higher prevalence of chronic human papillomavirus, resulting in increased risk for anal cancer [40]. In HIV-Leishmania coinfected patients, visceral leishmaniosis can accelerate disease, decreasing the likelihood of patient survival [41]. C. neoformans and H. capsulatum are the only agents that have been isolated, particularly from immunocompromised individuals [14,16].…”