Background: The management of visceral leishmaniasis (VL) in HIV-infected patients is often complex with patients experiencing higher mortality rates, more toxic side effects and a higher possibility of treatment failure and relapse than HIV-negative individuals with VL.
Case Presentation: We report on successful salvage therapy in two HIV-infected patients suffering with disseminated cutaneous and visceral leishmaniasis, recalcitrant to therapy with liposomal amphotericin B. After the employment of combination anti-leishmanial treatment, parasite genomes were not detectable up to the last follow up visit, 57 and 78 weeks after treatment onset, respectively. CD4+ lymphocyte counts fluctuated over time, but were generally higher than counts detected at treatment onset, which likely contributed to protection against VL relapse.
Conclusions: Results achieved with the anti-leishmanial combination treatment were promising, but are based on only two patients. Future investigation is necessary to confirm the efficacy of this salvage therapy in sustaining the immunological response and control of VL.
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http://dx.doi.org/10.1186/s12981-018-0215-x | DOI Listing |
Trans R Soc Trop Med Hyg
January 2025
Programa de Pós-Graduação em Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Avenida Presidente Antônio Carlos, 6627, Pampulha, CEP 31270901 Belo Horizonte, Minas Gerais, Brazil.
Background: In the Americas, visceral leishmaniasis (VL) results from the zoonotic transmission of Leishmania infantum. VL has a high occurrence rate in the Metropolitan Region of Belo Horizonte (BH), Minas Gerais, Brazil, and has rapidly spread throughout the municipality since it was first recorded in 1994. This research analysed a historical perspective over 25 y of human VL occurrence in BH.
View Article and Find Full Text PDFParasitol Res
January 2025
Department of Veterinary Medicine, University of Bari, Valenzano, Italy.
Canine leishmaniosis (CanL), caused by Leishmania infantum, is a widespread vector-borne disease. In Italy, an endemic region for CanL, overlapping transmission of L. infantum and tick-borne pathogens (TBPs) like Anaplasma phagocytophilum and Ehrlichia canis is increasingly reported.
View Article and Find Full Text PDFJ Parasitol Res
January 2025
Parasitology and Mycology Center, Adolfo Lutz Institute, Sao Paulo, Brazil.
Visceral leishmaniasis (VL) is a zoonotic disease in which dogs are the main reservoirs. Until now, the serological tests do not present satisfactory sensitivity for diagnosis of these hosts. One of the functions of extracellular vesicles (EVs) is related to immunological host response.
View Article and Find Full Text PDFCytokine
January 2025
Department of Molecular Biology and Bioinformatics, Tripura University, Agartala, India. Electronic address:
Transforming growth factor-beta (TGF-β), displaying a dual role in immunosuppression and pathogenesis, has emerged as a key regulator of anti-leishmanial immune responses. In Leishmania infections, TGF-β drives immune deviation by enhancing regulatory T-cell (T-reg) differentiation and inhibiting macrophage activation, suppressing critical antiparasitic responses. This cytokine simultaneously promotes fibroblast proliferation, extracellular matrix production, and fibrosis in infected tissues, which aids in wound healing but impedes immune cell infiltration, particularly in visceral leishmaniasis, where splenic disorganization and compromised immune access are notable.
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