TITLE

Predictors of Visceral Leishmaniasis Relapse in HIV-Infected Patients: A Systematic Review

AUTHOR(S)
Cota, Gláucia F.; Sousa, Marcos R. de; Rabello, Ana
PUB. DATE
June 2011
SOURCE
PLoS Neglected Tropical Diseases;Jun2011, Vol. 5 Issue 6, p1
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background and Objectives: Visceral leishmaniasis (VL) is a common complication in AIDS patients living in Leishmaniaendemic areas. Although antiretroviral therapy has changed the clinical course of HIV infection and its associated illnesses, the prevention of VL relapses remains a challenge for the care of HIV and Leishmania co-infected patients. This work is a systematic review of previous studies that have described predictors of VL relapse in HIV-infected patients. Review Methods: We searched the electronic databases of MEDLINE, LILACS, and the Cochrane Central Register of Controlled Trials. Studies were selected if they included HIV-infected individuals with a VL diagnosis and patient follow-up after the leishmaniasis treatment with an analysis of the clearly defined outcome of prediction of relapse. Results: Eighteen out 178 studies satisfied the specified inclusion criteria. Most patients were males between 30 and 40 years of age, and HIV transmission was primarily via intravenous drug use. Previous VL episodes were identified as risk factors for relapse in 3 studies. Two studies found that baseline CD4+ T cell count above 100 cells/mL was associated with a decreased relapse rate. The observation of an increase in CD4+ T cells at patient follow-up was associated with protection from relapse in 5 of 7 studies. Meta-analysis of all studies assessing secondary prophylaxis showed significant reduction of VL relapse rate following prophylaxis. None of the five observational studies evaluating the impact of highly active antiretroviral therapy use found a reduction in the risk of VL relapse upon patient follow-up. Conclusion: Some predictors of VL relapse could be identified: a) the absence of an increase in CD4+ cells at follow-up; b) lack of secondary prophylaxis; and c) previous history of VL relapse. CD4+ counts below 100 cells/mL at the time of primary VL diagnosis may also be a predictive factor for VL relapse.
ACCESSION #
77067078

 

Related Articles

  • Bilateral pedal edema in an HIV patient: Lopinavir/Ritonavir-containing treatment regimen as a potential cause? Shihab, Hasan M.; Lutwama, Fred; Piloya, Theresa; Castelnuovo, Barbara; Kambugu, Andrew D.; Colebunders, Robert // Journal of Infection in Developing Countries;2009, Vol. 3 Issue 5, p405 

    A large number of patients are switched to second-line antiretroviral therapy, especially in resource limited settings. Lopinavir/Ritonavir is the main drug used in second-line treatment regimens. We describe a patient attending an HIV treatment centre in Kampala, Uganda, who presented with...

  • Increased risk of deep neck infection among HIV-infected patients in the era of highly active antiretroviral therapy--a population-based follow-up study. Ching-Feng Liu; Shih-Feng Weng; Yung-Song Lin; Chih-Sheng Lin; Ching-Feng Lien; Jhi-Joung Wang // BMC Infectious Diseases;2013, Vol. 13 Issue 1, p1 

    Background: Deep neck infections (DNIs) in HIV-infected patients often produce severe complications, even death. Data on the incidence rates and risks of DNI among HIV-infected patients are scarce, particularly with the widespread use of highly active antiretroviral therapy (HAART). We evaluated...

  • Factors associated with adherence to antiretroviral therapy in HIV-infected patients in Kathmandu District, Nepal. Shigdel, Rajesh; Klouman, Elise; Bhandari, Anita; Ahmed, Luai A. // HIV/AIDS - Research & Palliative Care;2014, Vol. 6, p109 

    Purpose: There are a high number of HIV-infected patients receiving antiretroviral therapy (ART) in the Kathmandu District of Nepal, but information on adherence and factors influencing it are scarce in this population. The present study aimed to estimate ART adherence among HIV-infected...

  • Improved Virological Outcomes in British Columbia Concomitant with Decreasing Incidence of HIV Type 1 Drug Resistance Detection. Gill, Vikram S.; Lima, Viviane D.; Wen Zhang; Wynhoven, Brian; Yip, Benita; Hogg, Robert S.; Montaner, Julio S. G.; Richard Harrigan, P. // Clinical Infectious Diseases;1/1/2010, Vol. 50 Issue 1, p98 

    Background. There have been limited studies evaluating temporal changes in the incidence of detection of drug resistance among human immunodeficiency virus type 1 (HIV-1) isolates and concomitant changes in plasma HIV load for treated individuals in a population-wide setting. Methods....

  • Visceral Fat as Target of Highly Active Antiretroviral Therapy-Associated Metabolic Syndrome. Giuseppe Barbaro // Current Pharmaceutical Design;Jul2007, Vol. 13 Issue 21, p2208 

    HIV-associated lipodystrophy or lipoatrophy, unreported before the introduction of highly active antiretroviral therapy (HAART), was first described in 1998, and has a prevalence ranging from 18% to 83%. As in genetic lipodystrophy syndromes, fat redistribution may precede the development of...

  • Clinical Performance of a Dermal Filler Containing Natural Glycolic Acid and a Polylactic Acid Polymer. Tagle, Jorge M.; Macchetto, Pedro Cervantes; Páramo, Rosa Margarita Durán // Journal of Clinical & Aesthetic Dermatology;Feb2010, Vol. 3 Issue 2, p42 

    Lipoatrophy is a condition that affects certain individuals, most commonly those who are infected with the human immunodeficiency virus. Injectable fillers are used for the treatment of these dermal contour deformities to smooth dermal depressions formed by the loss of volume. These dermal...

  • Pre-existing Minority Drug-Resistant HIV-1 Variants, Adherence, and Risk of Antiretroviral Treatment Failure. Paredes, Roger; Lalama, Christina M.; Ribaudo, Heather J.; Schackman, Bruce R.; Shikuma, Cecilia; Giguel, Francoise; Meyer III, William A.; Johnson, Victoria A.; Fiscus, Susan A.; D'Aquila, Richard T.; Gulick, Roy M.; Kuritzkes, Daniel R. // Journal of Infectious Diseases;3/1/2010, Vol. 201 Issue 5, p662 

    Background. The clinical relevance of detecting minority drug-resistant human immunodeficiency virus type 1 (HIV-1) variants is uncertain. Methods. To determine the effect of pre-existing minority nonnucleoside reverse-transcriptase inhibitor (NNRTI)-resistant variants on the risk of virologic...

  • HIV treatment prevents transmission of HIV.  // Africa Health;May2011, Vol. 33 Issue 4, p11 

    The article discusses the report from the US National Institutes of Health which found that an effective antiretroviral therapy regimen for HIV-positive person could prevent the risk of transmitting the virus to their uninfected sexual partner.

  • Detection of immunological treatment failure among HIV infected patients in Ethiopia: a retrospective cohort study. Teshome, Wondu; Tefera, Ambachew // BMC Immunology;9/17/2015, Vol. 16 Issue 1, p1 

    Background: Timely detection of treatment failure with subsequent switch to second-line regimen reduces mortality among HIV infected people on antiretroviral therapy (ART). This paper aims to investigate the detection of immunological treatment failure and switch rate to second line regimen in...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics