Visceral leishmaniasis in patients infected with the human immunodeficiency virus

  • F. Laguna
  • M. Adrados
  • J. Alvar
  • V. Soriano
  • M. E. Valencia
  • V. Moreno
  • R. Polo
  • J. Verdejo
  • M. I. Jiménez
  • P. Martínez
  • M. L. Martínez
  • J. M. González-Lahoz
Article

DOI: 10.1007/BF01700556

Cite this article as:
Laguna, F., Adrados, M., Alvar, J. et al. Eur. J. Clin. Microbiol. Infect. Dis. (1997) 16: 898. doi:10.1007/BF01700556

Abstract

The experience with 52 episodes of visceral leishmaniasis diagnosed in 43 patients is reported. The most common symptoms were fever (81%), splenomegaly (65%), hepatomegaly (63%), and pancytopenia (73%). In 79% of the patients, CD4+ cell counts were <100 cells/mm3. Prior or simultaneous diagnosis of AIDS was made in 29 (67%) patients. Diagnosis was considered fortuitous in 19% of the episodes. In 27% of the episodes, the diagnosis was made on the basis of demonstration of parasites outside the reticuloendothelial system, chiefly blood (7 cases) and gastrointestinal mucosa (5 cases). Parasites were frequently observed or cultured from blood (22/37 episodes) or the digestive tract (8/9 episodes). High antimony doses were more effective than low doses in achieving clinical or parasitological cure (rate of cure, 80% vs. 40%, p=0.11). Severe toxicity was observed in six (11.7%) of the 51 treated episodes. Severe AIDS-related diseases [odds ratio (OR) 10, p<0.05] and CD4+ counts (OR 12, p<0.05) were independent factors for early death. Prophylaxis with monthly pentamidine was not useful in reducing relapses of visceral leishmaniasis.

Copyright information

© MMV Medizin Verlag GmbH 1997

Authors and Affiliations

  • F. Laguna
    • 1
  • M. Adrados
    • 1
  • J. Alvar
    • 2
  • V. Soriano
    • 1
  • M. E. Valencia
    • 1
  • V. Moreno
    • 1
  • R. Polo
    • 1
  • J. Verdejo
    • 1
  • M. I. Jiménez
    • 2
  • P. Martínez
    • 3
  • M. L. Martínez
    • 1
  • J. M. González-Lahoz
    • 1
  1. 1.Servicio de Enfermedades InfecciosasCentro Nacional de Investigación Clínica, Instituto de Salud Carlos IIIMadridSpain
  2. 2.Servicio de HematologíaCentro Nacional de Investigación Clínica, Instituto de Salud Carlos IIIMadridSpain
  3. 3.Laboratorio de Referencia de LeishmaniasisCentro Nacional de Microbiología, Instituto de Salud Carlos IIIMajadahonda, MadridSpain

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