Prevalence of Leishmania infection among AIDS patients

Alvar, Jorge; Gutiérrez-Solar, B; Molina, Ricardo; López‐Vélez, Rogelio; García-Camacho, Alinka Socorro; Martínez, Pilar; Laguna, Fernando Ballester; Cercenado, Emilia; Galmés, Antonio

doi:10.1016/0140-6736(92)91255-7

Cited by 85 publications

(31 citation statements)

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“…The largest number of cases was consistently detected in Spain, which may be related to the reactivation of asymptomatic infections due to a greater geographical overlap between leishmaniasis and HIV infections compared with that for other southern European countries. However, it has also been demonstrated that newly acquired infections occur among intravenous drug users (IVDU) sharing Leishmania-infected syringes (11,70,186,187), and at the time of these studies, Spain had five to seven times more IVDU than the European average. However, the proportion of reactivated leishmaniasis cases in asymptomatic coinfected patients compared with coinfected cases due to contaminated syringes has not been established.…”

Section: Leishmania-hiv Coinfection Southern Europementioning

confidence: 99%

The Relationship between Leishmaniasis and AIDS: the Second 10 Years

et al. 2008

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SUMMARY To date, most Leishmania and human immunodeficiency virus (HIV) coinfection cases reported to WHO come from Southern Europe. Up to the year 2001, nearly 2,000 cases of coinfection were identified, of which 90% were from Spain, Italy, France, and Portugal. However, these figures are misleading because they do not account for the large proportion of cases in many African and Asian countries that are missed due to a lack of diagnostic facilities and poor reporting systems. Most cases of coinfection in the Americas are reported in Brazil, where the incidence of leishmaniasis has spread in recent years due to overlap with major areas of HIV transmission. In some areas of Africa, the number of coinfection cases has increased dramatically due to social phenomena such as mass migration and wars. In northwest Ethiopia, up to 30% of all visceral leishmaniasis patients are also infected with HIV. In Asia, coinfections are increasingly being reported in India, which also has the highest global burden of leishmaniasis and a high rate of resistance to antimonial drugs. Based on the previous experience of 20 years of coinfection in Europe, this review focuses on the management of Leishmania-HIV-coinfected patients in low-income countries where leishmaniasis is endemic.

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Section: Leishmania-hiv Coinfection Southern Europementioning

confidence: 99%

The Relationship between Leishmaniasis and AIDS: the Second 10 Years

et al. 2008

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“…Five hundred thousand new cases of VL occur each year. Further, the presence of subclinical infection in these areas has become evident in patients with AIDS (3,35).…”

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confidence: 99%

Intradermal Infection Model for Pathogenesis and Vaccine Studies of Murine Visceral Leishmaniasis

et al. 2003

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The levels of protection found in vaccine studies of murine visceral leishmaniasis are significantly lower than for cutaneous leishmaniasis; whether this is due to the high-challenge murine model employed and/or is a consequence of differences required in tissue-specific local immune responses is not understood. Consequently, an intradermal murine model of visceral leishmaniasis has been explored. Intradermal inoculation established a chronic infection in susceptible mice which was associated with a pattern of parasite clearance with time postinfection in the liver and skin; in contrast, parasite persistence and expansion was observed in lymphoid tissue (spleen and draining lymph node). The course of disease found appears to be similar to those reported for subclinical canine and human visceral leishmaniasis. Clearance of parasites from the skin was correlated with an inflammatory response and the infiltration and activation of CD4 ؉ and CD8 ؉ T cells. In contrast, in lymphoid tissue (lymph node or spleen), the production of Th1/Th2 cytokines (interleukin-4 [IL-4], IL-10, and gamma interferon) appeared to correlate with parasite burden and pathogenesis. In vaccination experiments employing the Leishmania infantum D-13 (p80) antigen, significantly higher levels of protection were found with the intradermal murine model (29 to 7,500-fold more than naive controls) than were found with a low-dose intravenous infection model (9 to 173-fold). Thus, this model should prove useful for further investigation of disease pathogenesis as well as vaccine studies of visceral leishmaniasis.

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“…Visceral leishmaniasis (VL) is the most severe form of the disease because it is lethal if not treated [2]. It is important to note that in Europe, L. infantum has emerged as an opportunist pathogen in HIV patients in which the depletion of CD4 explains the tendancy to relapse if immunosuppression is not controlled by an antiretroviral therapy [3,4].…”

Section: Introductionmentioning

confidence: 99%

Development of new antileishmanial drugs – current knowledge and future prospects

Pape

2008

Journal of Enzyme Inhibition and Medicinal Chemistry

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Leishmaniasis is a protozoan vector borne disease prevalent throughout the world and present in at least 88 countries. The parasite is transmitted by infected phlebotomine sandfly bites. While conventional therapies i.e. pentavalent antimonials, amphotericin B and pentamidine continue to play a major role, it is evident that new drugs or strategies must circumvent the limitations, such as a long-term parenteral administration, toxicity, the high cost in endemic countries and the emergence of resistance, that prevail. One of the most promising drugs is miltefosine, a new oral, approved alkylphospholipid for visceral leishmaniasis with only slight adverse effects. Although we have now this recent and encouraging advance, there is still a need to develop safe, efficient and affordable new treatments for the different clinical forms that exist. This review summarises conventional therapy and the current efforts in the discovery of drugs to treat leishmaniasis with the emphasis on drug combinations to enhance efficiency and prevent the emergence of resistance, the investigation of natural products with the objective of offering new bioactive chemical structures and the development of novel antileishmanial targets.

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Prevalence of Leishmania infection among AIDS patients

Cited by 85 publications

References 1 publication

The Relationship between Leishmaniasis and AIDS: the Second 10 Years

The Relationship between Leishmaniasis and AIDS: the Second 10 Years

Intradermal Infection Model for Pathogenesis and Vaccine Studies of Murine Visceral Leishmaniasis

Development of new antileishmanial drugs – current knowledge and future prospects

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