Article
Treatment failure in leishmaniasis: drug-resistance or another (epi-) phenotype?
Registro en:
1478-7210
1744-8336
Autor
Vanaerschot, Manu
Dumetz, Franck
Roy, Syamal
Ponte-Sucre, Alicia
Arevalo, Jorge
Dujardin, Jean Claude
Institución
Resumen
Two major leishmaniasis treatments have shown a significant decrease in effectiveness in the
last few decades, mostly in the Indian subcontinent but also in other endemic areas. Drug
resistance of Leishmania correlated only partially to treatment failure (TF) of pentavalent
antimonials, and has so far proved not to be important for the increased miltefosine relapse
rates observed in the Indian subcontinent. While other patient- or drug-related factors could
also have played a role, recent studies identified several parasite features such as infectivity
and host manipulation skills that might contribute to TF. This perspective aims to discuss how
different parasitic features other than drug resistance can contribute to TF of leishmaniasis
and how this may vary between different epidemiological contexts European Commission
(Kaladrug-R, FP7-222895), the Belgian Development Cooperation
(FA3 II VL control and FA3 project 95502), the Belgian Science Policy
Office (TRIT, P7/41), the Flemish Fund for Scientific Research
(G.0.B81.12), the Alexander von Humboldt Foundation (CDCHUCV
PI-09-8717-2013/1) and the Universidad Central de Venezuela
Council for Research (PG-09-8646-2013/1).