Pancreatic involvement in co-infection visceral leishmaniasis and HIV: histological and ultrastructural aspects

Chehter, Ethel Zimberg; Longo, Maria Antonieta; Laudanna, Antônio Atílio; Duarte, Maria Irma Seixas

doi:10.1590/s0036-46652001000200004

Cited by 8 publications

(4 citation statements)

References 8 publications

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“…In fact, atypical clinical cases have been reported in Latin America, including the involvement of the gastrointestinal tract (duodenum and pancreas) and kidney [52], [58], [59]. However, based on the 356 cases reported so far (Table 1), the major clinical presentation of VL-HIV-coinfected patients in the Americas is quite similar to that observed for VL in non-HIV-infected patients and in Mediterranean coinfected patients.…”

Section: Clinical Aspectsmentioning

confidence: 80%

Visceral Leishmaniasis and HIV Coinfection in Latin America

et al. 2014

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Visceral leishmaniasis (VL) is an endemic zoonotic disease in Latin America caused by Leishmania (Leishmania) infantum, which is transmitted by sand flies from the genus Lutzomyia. VL occurs in 12 countries of Latin America, with 96% of cases reported in Brazil. Recently, an increase in VL, primarily affecting children and young adults, has been observed in urban areas of Latin America. The area in which this spread of VL is occurring overlaps regions with individuals living with HIV, the number of whom is estimated to be 1.4 million people by the World Health Organization. This overlap is suggested to be a leading cause of the increased number of reported VL-HIV coinfections. The clinical progression of HIV and L. infantum infections are both highly dependent on the specific immune response of an individual. Furthermore, the impact on the immune system caused by either pathogen and by VL-HIV coinfection can contribute to an accelerated progression of the diseases. Clinical presentation of VL in HIV positive patients is similar to patients without HIV, with symptoms characterized by fever, splenomegaly, and hepatomegaly, but diarrhea appears to be more common in coinfected patients. In addition, VL relapses are higher in coinfected patients, affecting 10% to 56.5% of cases and with a lethality ranging from 8.7% to 23.5% in Latin America, depending on the study. With regards to the diagnosis of VL, parasitological tests of bone marrow aspirates have proven to be the most sensitive test in HIV-infected patients. Serologic tests have demonstrated a variable sensitivity according to the method and antigens used, with the standard tests used for diagnosing VL in Latin America displaying lower sensitivity. For this review, few articles were identified that related to VL-HIV coinfections and originated from Latin America, highlighting the need for improving research within the regions most greatly affected. We strongly support the formation of a Latin American network for coinfections of Leishmania and HIV to improve the consistency of research on the current situation of VL-HIV coinfections. Such a network would improve the collection of vital data and samples for better understanding of the clinical manifestations and immunopathogenic aspects of VL in immunosuppressed patients. Ultimately, a concerted effort would improve trials for new diagnostic methodologies and therapeutics, which could accelerate the implementation of more specific and effective diagnosis as well as public policies for treatments to reduce the impact of VL-HIV coinfections on the Latin American population.

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Section: Clinical Aspectsmentioning

confidence: 80%

Visceral Leishmaniasis and HIV Coinfection in Latin America

et al. 2014

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“…There are also a few reports of HIV-infected mucocutaneous leishmaniasis patients, associated or not with cutaneous lesions 4,10,15,23 . In a recent case report CHEHTER et al 3 described the involvement of the gastrointestinal tract and dissemination forms of Leishmania, in co-infection visceral leishmaniasis and HIV patient. In the present paper, atypical VL was caused by L. braziliensis and the patient did not show cutaneous or mucosal lesions.…”

Section: Discussionmentioning

confidence: 99%

Visceral leishmaniasis caused by Leishmania (Viannia) braziliensis in a patient infected with human immunodeficiency virus

Silva

Pacheco

Gontijo³

et al. 2002

Rev. Inst. Med. trop. S. Paulo

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The current article reports the case of a 19-month-old-girl, from the state of Minas Gerais, Brazil, with visceral leishmaniasis, by Leishmania (Viannia) braziliensis, and Human Immunodeficiency Virus (HIV) co-infection. The child's mother and father, aged 22 and 27 years old, respectively, were both HIV positive. The child was admitted to the General Pediatric Center, in Belo Horizonte, presenting high fever, fatigue, weight loss and enlargement of liver and spleen. Indirect immunofluorescent test revealed a titer of 1:320 for Leishmania. Such result was confirmed by the presence of amastigotes in bone marrow aspirate samples and culture of promastigote forms. Parasites were identified as being Leishmania (Viannia) braziliensis through PCR, using a L. braziliensis complex primer and a generic primer, followed by hibridization. Specific leishmaniasis therapy (Glucantime register mark or target antimonial) was intravenously administered.

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“…In other cases of Leishmania-HIV coinfection, involvement of the lungs (83,362,584), gastrointestinal system (83,362), pancreas (104), and eye (239) has also been reported.…”

Section: Leishmaniamentioning

confidence: 99%

Importance of Nonenteric Protozoan Infections in Immunocompromised People

et al. 2010

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SUMMARY There are many neglected nonenteric protozoa able to cause serious morbidity and mortality in humans, particularly in the developing world. Diseases caused by certain protozoa are often more severe in the presence of HIV. While information regarding neglected tropical diseases caused by trypanosomatids and Plasmodium is abundant, these protozoa are often not a first consideration in Western countries where they are not endemic. As such, diagnostics may not be available in these regions. Due to global travel and immigration, this has become an increasing problem. Inversely, in certain parts of the world (particularly sub-Saharan Africa), the HIV problem is so severe that diseases like microsporidiosis and toxoplasmosis are common. In Western countries, due to the availability of highly active antiretroviral therapy (HAART), these diseases are infrequently encountered. While free-living amoebae are rarely encountered in a clinical setting, when infections do occur, they are often fatal. Rapid diagnosis and treatment are essential to the survival of patients infected with these organisms. This paper reviews information on the diagnosis and treatment of nonenteric protozoal diseases in immunocompromised people, with a focus on patients infected with HIV. The nonenteric microsporidia, some trypanosomatids, Toxoplasma spp., Neospora spp., some free-living amoebae, Plasmodium spp., and Babesia spp. are discussed.

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Pancreatic involvement in co-infection visceral leishmaniasis and HIV: histological and ultrastructural aspects

Cited by 8 publications

References 8 publications

Visceral Leishmaniasis and HIV Coinfection in Latin America

Visceral Leishmaniasis and HIV Coinfection in Latin America

Visceral leishmaniasis caused by Leishmania (Viannia) braziliensis in a patient infected with human immunodeficiency virus

Importance of Nonenteric Protozoan Infections in Immunocompromised People

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