BACKGROUND AND OBJECTIVES: Visceral leishmaniasis (VL) is characterized by frequent relapses in HIV-infected patients, even in those who receive secondary prophylaxis. The aim of our study was to evaluate the efficacy of liposomal amphotericin B (L-AMB) for secondary prophylaxis of VL in HIV-infected patients. METHODS: From January 2001 to December 2005, 17 HIV patients, with at least one previous episode of VL who received L-AMB as secondary prophylaxis for VL, were included in the study. Efficacy was measured as the proportion of patients remaining free (non-relapse) of VL at different time points. Relapses were analysed as time-to-relapse distribution and were evaluated by survival analysis using the Kaplan-Meier method. RESULTS: Twenty-one episodes of VL were diagnosed and nine relapsed. The median follow-up time was 14 (5-44) months. The probability of remaining free of relapse at 6 months was 89.7% (95% CI, 76.2-100); at 12 months, the probability was 79.1% (95% CI, 61-97.2) and at 24 and 36 months, the probability was 55.9% (95% CI, 30.5-81.3). In the non-relapsing group, patients had a significant increase in CD4 cell levels of 102 (10-174) and 126 (4-159) cells/mm(3) at 12 and 24 months, respectively (P = 0.037), whereas in the relapsing group, no significant increase was observed. Prophylaxis with L-AMB was well tolerated and only three patients had a mild impairment of renal function without requiring any change in treatment. CONCLUSIONS: L-AMB is well tolerated and useful for secondary prophylaxis of VL.
BACKGROUND AND OBJECTIVES:Visceral leishmaniasis (VL) is characterized by frequent relapses in HIV-infectedpatients, even in those who receive secondary prophylaxis. The aim of our study was to evaluate the efficacy of liposomal amphotericin B (L-AMB) for secondary prophylaxis of VL in HIV-infectedpatients. METHODS: From January 2001 to December 2005, 17 HIVpatients, with at least one previous episode of VL who received L-AMB as secondary prophylaxis for VL, were included in the study. Efficacy was measured as the proportion of patients remaining free (non-relapse) of VL at different time points. Relapses were analysed as time-to-relapse distribution and were evaluated by survival analysis using the Kaplan-Meier method. RESULTS: Twenty-one episodes of VL were diagnosed and nine relapsed. The median follow-up time was 14 (5-44) months. The probability of remaining free of relapse at 6 months was 89.7% (95% CI, 76.2-100); at 12 months, the probability was 79.1% (95% CI, 61-97.2) and at 24 and 36 months, the probability was 55.9% (95% CI, 30.5-81.3). In the non-relapsing group, patients had a significant increase in CD4 cell levels of 102 (10-174) and 126 (4-159) cells/mm(3) at 12 and 24 months, respectively (P = 0.037), whereas in the relapsing group, no significant increase was observed. Prophylaxis with L-AMB was well tolerated and only three patients had a mild impairment of renal function without requiring any change in treatment. CONCLUSIONS:L-AMB is well tolerated and useful for secondary prophylaxis of VL.
Authors: Kathryn M Dupnik; Eliana L Nascimento; Joao F Rodrigues-Neto; Tatjana Keesen; Maria Zélia Fernandes; Iraci Duarte; Selma M B Jeronimo Journal: Drug Dev Res Date: 2011-09 Impact factor: 4.360
Authors: Israel Molina; Roser Fisa; Cristina Riera; Vicenç Falcó; Aleix Elizalde; Fernando Salvador; Manuel Crespo; Adrian Curran; Paulo López-Chejade; Silvia Tebar; Santiago Pérez-Hoyos; Esteban Ribera; Albert Pahissa Journal: Am J Trop Med Hyg Date: 2013-04-29 Impact factor: 2.345
Authors: Jane E Dalton; Asher Maroof; Benjamin M J Owens; Priyanka Narang; Katherine Johnson; Najmeeyah Brown; Lovisa Rosenquist; Lynette Beattie; Mark Coles; Paul M Kaye Journal: J Clin Invest Date: 2010-03-15 Impact factor: 14.808