OBJECTIVE: To investigate the epidemiological, clinical and biological features of visceral leishmaniasis (VL) in patients with HIV-1 infection. DESIGN: Retrospective study. SETTING: Three university hospitals in southern Spain. PATIENTS: Forty-seven adult patients with VL and HIV-1 infection diagnosed between January 1986 and November 1991. RESULTS: Forty-five out of the 47 (96%) cases were diagnosed in the last 2 years. Fever (87%), hepatomegaly (74%), splenomegaly (72%) and pancytopenia (77%) were the most common presenting features. Most patients (79%) were strongly immunocompromised when VL was diagnosed, and were in stage IV of the Centers for Disease Control classification; 87% had a CD4 lymphocyte count < 200 x 10(6)/l. However, VL was the first severe infection diagnosed in 10 cases. Significant titres (> 1:40) of antileishmanial antibodies were detected by indirect immunofluorescence in five out of 16 (31%) cases only. Clinical response to the therapy was difficult to assess. Microbiological response was achieved in only 38% of the patients evaluated. CONCLUSIONS: Leishmaniasis is a relatively common infection in HIV-1-infected individuals in southern Spain. Its clinical picture is quite uniform and it can be the first opportunistic infection in individuals with HIV-1. In endemic areas, a high index of clinical suspicion should be maintained in order to avoid underdiagnosis of leishmaniasis.
OBJECTIVE: To investigate the epidemiological, clinical and biological features of visceral leishmaniasis (VL) in patients with HIV-1 infection. DESIGN: Retrospective study. SETTING: Three university hospitals in southern Spain. PATIENTS: Forty-seven adult patients with VL and HIV-1 infection diagnosed between January 1986 and November 1991. RESULTS: Forty-five out of the 47 (96%) cases were diagnosed in the last 2 years. Fever (87%), hepatomegaly (74%), splenomegaly (72%) and pancytopenia (77%) were the most common presenting features. Most patients (79%) were strongly immunocompromised when VL was diagnosed, and were in stage IV of the Centers for Disease Control classification; 87% had a CD4 lymphocyte count < 200 x 10(6)/l. However, VL was the first severe infection diagnosed in 10 cases. Significant titres (> 1:40) of antileishmanial antibodies were detected by indirect immunofluorescence in five out of 16 (31%) cases only. Clinical response to the therapy was difficult to assess. Microbiological response was achieved in only 38% of the patients evaluated. CONCLUSIONS:Leishmaniasis is a relatively common infection in HIV-1-infected individuals in southern Spain. Its clinical picture is quite uniform and it can be the first opportunistic infection in individuals with HIV-1. In endemic areas, a high index of clinical suspicion should be maintained in order to avoid underdiagnosis of leishmaniasis.
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Keywords:
Acquired Immunodeficiency Syndrome; Antibodies; Biology; Developed Countries; Diseases; Europe; Hiv Infections; Immunity; Immunologic Factors; Information; Information Processing; Mediterranean Countries; Parasitic Diseases; Physiology; Records; Research Methodology; Research Report; Retrospective Studies; Risk Factors; Signs And Symptoms; Southern Europe; Spain; Studies; Viral Diseases
Authors: J A Pineda; J Hernández-Quero; J A Gallardo; M A López-Ruz; M A Martínez-Pérez; J Macías; E Lissen Journal: Eur J Clin Microbiol Infect Dis Date: 1996-03 Impact factor: 3.267
Authors: F Lozano; J Torre-Cisneros; A Bascuñana; J Polo; P Viciana; M A García-Ordóñez; J Hernández-Quero; M Márquez; A Vergara; F Díez; E Pujol; M Torres-Tortosa; J Pasquau; J J Hernández-Burruezo; I Suárez Journal: Eur J Clin Microbiol Infect Dis Date: 1996-09 Impact factor: 3.267
Authors: J Alvar; C Cañavate; B Gutiérrez-Solar; M Jiménez; F Laguna; R López-Vélez; R Molina; J Moreno Journal: Clin Microbiol Rev Date: 1997-04 Impact factor: 26.132
Authors: J A Pineda; J A Gallardo; J Macías; J Delgado; C Regordán; F Morillas; F Relimpio; J Martín-Sánchez; A Sánchez-Quijano; M Leal; E Lissen Journal: J Clin Microbiol Date: 1998-09 Impact factor: 5.948
Authors: F J Medrano; C Rey; M Leal; C Cañavate; A Rubio; A Sánchez-Quijano; J Alvar; E Lissen Journal: Clin Exp Immunol Date: 1998-12 Impact factor: 4.330