Visceral Leishmaniasis and HIV Coinfection in East Africa |
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| Authors: | Ermias Diro Lutgarde Lynen Koert Ritmeijer Marleen Boelaert Asrat Hailu Johan van Griensven |
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| Institution: | 1. Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.; 2. Department of Internal Medicine, University of Gondar, Gondar, Ethiopia.; 3. Public Health Department, Médecins Sans Frontières, Amsterdam, the Netherlands.; 4. Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.; 5. School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia.; National Institute of Allergy and Infectious Diseases, United States of America, |
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| Abstract: | Visceral Leishmaniasis (VL) is an important protozoan opportunistic disease in HIV patients in endemic areas. East Africa is second to the Indian subcontinent in the global VL caseload and first in VL-HIV coinfection rate. Because of the alteration in the disease course, the diagnostic challenges, and the poor treatment responses, VL with HIV coinfection has become a very serious challenge in East Africa today. Field experience with the use of liposomal amphotericin B in combination with miltefosine, followed by secondary prophylaxis and antiretroviral drugs, looks promising. However, this needs to be confirmed through clinical trials. Better diagnostic and follow-up methods for relapse and prediction of relapse should also be looked for. Basic research to understand the immunological interaction of the two infections may ultimately help to improve the management of the coinfection. |
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