dc.creatorCota, Gláucia Fernandes
dc.creatorSousa, Marcos Roberto de
dc.creatorMendonça, Andrea Laender Pessoa de
dc.creatorPatrocinio, Allan
dc.creatorAssunçao, Luiza Siqueira
dc.creatorFaria, Sidnei Rodrigues de
dc.creatorRabello, Ana Lucia Teles
dc.date2015-02-19T15:28:58Z
dc.date2015-02-19T15:28:58Z
dc.date2014
dc.date.accessioned2023-09-26T23:25:33Z
dc.date.available2023-09-26T23:25:33Z
dc.identifierCOTA, Gláucia Fernandes et al. Leishmania-HIV Co-infection: Clinical Presentation and Outcomes in an Urban Area in Brazil. PLoS Neglected Tropical Diseases, v. 8, n. 4, p. 1-7, Apr. 2014.
dc.identifier1935-2735
dc.identifierhttps://www.arca.fiocruz.br/handle/icict/9501
dc.identifier10.1371/journal.pntd.0002816
dc.identifier.urihttps://repositorioslatinoamericanos.uchile.cl/handle/2250/8890438
dc.descriptionBACKGROUND: Visceral leishmaniasis (VL) is an emerging condition affecting HIV-infected patients living in Latin America, particularly in Brazil. Leishmania-HIV coinfection represents a challenging diagnosis because the clinical picture of VL is similar to that of other disseminated opportunistic diseases. Additionally, coinfection is related to treatment failure, relapse and high mortality. OBJECTIVE: To assess the clinical-laboratory profile and outcomes of VL-HIV-coinfected patients using a group of non HIV-infected patients diagnosed with VL during the same period as a comparator. METHODS: The study was conducted at a reference center for infectious diseases in Brazil. All patients with suspected VL were evaluated in an ongoing cohort study. Confirmed cases were divided into two groups: with and without HIV coinfection. Patients were treated according to the current guidelines of the Ministry of Health of Brazil, which considers antimony as the first-choice therapy for non HIV-infected patients and recommends amphotericin B for HIV-infected patients. After treatment, all patients with CD4 counts below 350 cells/mm3 received secondary prophylaxis with amphotericin B. RESULTS: Between 2011 and 2013, 168 patients with suspected VL were evaluated, of whom 90 were confirmed to have VL. In total, 51% were HIV coinfected patients (46 patients). HIV-infected patients had a lower rate of fever and splenomegaly compared with immunocompetent patients. The VL relapse rate in 6 months was 37% among HIV-infected patients, despite receiving secondary prophylaxis. The overall case-fatality rate was 6.6% (4 deaths in the HIV-infected group versus 2 deaths in the non HIV-infected group). The main risk factors for a poor outcome at 6 months after the end of treatment were HIV infection, bleeding and a previous VL episode. CONCLUSION: Although VL mortality rates among HIV-infected individuals are close to those observed among immunocompetent patients treated with amphotericin B, HIV coinfection is related to a low clinical response and high relapse rates within 6 months.
dc.formatapplication/pdf
dc.languageeng
dc.publisherPublic Library of Science
dc.rightsopen access
dc.subjectBrazil
dc.subjectCoinfection
dc.subjectCoinfection
dc.subjectLeishmaniasis Visceral
dc.subjectHIV Infections
dc.subjectEpidemiology
dc.subjectComplications
dc.titleLeishmania-HIV Co-infection: Clinical Presentation and Outcomes in an Urban Area in Brazil
dc.typeArticle


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