HIV/AIDS-associated visceral leishmaniasis in patients from an endemic area in Central-west Brazil

Memórias do Instituto Oswaldo Cruz

Priscilla Alexandrino-de-oliveira²  Joanna Reis Santos-oliveira²  Maria Elizabeth Cavalheiros Dorval¹  Francisco Das Chagas Brandão Da-costa¹  Gracy Regina Oliveira Leite Pereira¹  Rivaldo Venâncio Da Cunha¹  Anamaria Mello Miranda Paniago¹  Alda Maria Da-cruz² 

[1] ,Instituto Oswaldo Cruz-Fiocruz Laboratório Interdisciplinar de Pesquisas Médicas Rio de Janeiro RJ ,Brasil

关键词: HIV/AIDS;    opportunistic infection;    Brazil;    visceral leishmaniasis;    intravenous drug users;    recurrence;   

DOI  :  10.1590/S0074-02762010000500016

来源: SciELO

【 摘 要 】

An increase in morbidity associated with visceral leishmaniasis (VL) in human immunodeficiency virus (HIV)/AIDS patients has been described in Africa and the Mediterranean. Despite the high endemicity of VL and HIV-1/AIDS in Brazil, this association has not been thoroughly investigated. Our aim was to evaluate the epidemiologic and clinical characteristics of VL-HIV-1/AIDS cases from Central-west [Mato Grosso do Sul (MS)] Brazil. Medical records of 23 VL-HIV-1/AIDS patients were reviewed. Patients were predominantly adult males (87%) and 34.8% of the patients were intravenous drug users (IVDU). Leishmaniasis was the first opportunistic infection in 60% of the HIV-1 patients. Fever occurred in all patients, although splenomegaly and hepatomegaly were absent in 21.7% of the cases. CD4+ T-cell counts were below 200 cells/mm³ in 80% of the cases and the counts did not increase after clinical remission despite antiretroviral therapy. The first drug chosen to treat the cases was antimonial, but the therapeutic regimen was altered to amphotericin B in 12 of 17 cases due to side effects. Relapses were reported in 56.5% of the patients. IVDU may constitute an important risk factor for the transmission of both diseases in MS. VL-HIV-1/AIDS patients in MS share similar clinical characteristics as those from other endemic regions worldwide. Thus, these findings are critical for improving the surveillance of VL-HIV/AIDS patients.

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