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Influence of Leishmania (Viannia) species on the response to antimonial treatment in patients with American tegumentary leishmaniasis.
J Infect Dis. 2007 Jun 15; 195(12):1846-51.JI

Abstract

BACKGROUND

Pentavalent antimonials (SbV) are the first-line chemotherapy for American tegumentary leishmaniasis (ATL). There are, however, reports of the occurrence of treatment failure with these drugs. Few studies in Latin America have compared the response to SbV treatment in ATL caused by different Leishmania species.

METHODS

Clinical parameters and response to SbV chemotherapy were studied in 103 patients with cutaneous leishmaniasis (CL) in Peru. Leishmania isolates were collected before treatment and typed by multilocus polymerase-chain-reaction restriction fragment-length polymorphism analysis.

RESULTS

The 103 isolates were identified as L. (Viannia) peruviana (47.6%), L. (V.) guyanensis (23.3%), L. (V.) braziliensis (22.3%), L. (V.) lainsoni (4.9%), L. (Leishmania) mexicana (1%), and a putative hybrid, L. (V.) braziliensis/L. (V.) peruviana (1%). L. (V.) guyanensis was most abundant in central Peru. Of patients infected with the 3 former species, 21 (21.9%) did not respond to SbV chemotherapy. The proportions of treatment failure (after 12 months of follow-up) were 30.4%, 24.5%, and 8.3% in patients infected with L. (V.) braziliensis, L. (V.) peruviana, and L. (V.) guyanensis, respectively. Infection with L. (V.) guyanensis was associated with significantly less treatment failure than L. (V.) braziliensis, as determined by multiple logistic regression analysis (odds ratio, 0.07 [95% confidence interval, 0.007-0.8]; P=.03).

CONCLUSIONS

Leishmania species can influence SbV treatment outcome in patients with CL. Therefore, parasite identification is of utmost clinical importance, because it should lead to a species-oriented treatment.

Authors+Show Affiliations

Instituto de Medicina Tropical Alexander von Humboldt, Facultad de Ciencias, Universidad Peruana Cayetano Heredia, Lima, Peru, and Hôpitaux Universitaires de Genève, Department of Community Medicine, Switzerland. biomoljazz@gmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17492601

Citation

Arevalo, Jorge, et al. "Influence of Leishmania (Viannia) Species On the Response to Antimonial Treatment in Patients With American Tegumentary Leishmaniasis." The Journal of Infectious Diseases, vol. 195, no. 12, 2007, pp. 1846-51.
Arevalo J, Ramirez L, Adaui V, et al. Influence of Leishmania (Viannia) species on the response to antimonial treatment in patients with American tegumentary leishmaniasis. J Infect Dis. 2007;195(12):1846-51.
Arevalo, J., Ramirez, L., Adaui, V., Zimic, M., Tulliano, G., Miranda-Verástegui, C., Lazo, M., Loayza-Muro, R., De Doncker, S., Maurer, A., Chappuis, F., Dujardin, J. C., & Llanos-Cuentas, A. (2007). Influence of Leishmania (Viannia) species on the response to antimonial treatment in patients with American tegumentary leishmaniasis. The Journal of Infectious Diseases, 195(12), 1846-51.
Arevalo J, et al. Influence of Leishmania (Viannia) Species On the Response to Antimonial Treatment in Patients With American Tegumentary Leishmaniasis. J Infect Dis. 2007 Jun 15;195(12):1846-51. PubMed PMID: 17492601.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Influence of Leishmania (Viannia) species on the response to antimonial treatment in patients with American tegumentary leishmaniasis. AU - Arevalo,Jorge, AU - Ramirez,Luis, AU - Adaui,Vanessa, AU - Zimic,Mirko, AU - Tulliano,Gianfranco, AU - Miranda-Verástegui,César, AU - Lazo,Marcela, AU - Loayza-Muro,Raúl, AU - De Doncker,Simonne, AU - Maurer,Anne, AU - Chappuis,Francois, AU - Dujardin,Jean-Claude, AU - Llanos-Cuentas,Alejandro, Y1 - 2007/05/03/ PY - 2006/10/10/received PY - 2007/01/10/accepted PY - 2007/5/12/pubmed PY - 2007/7/11/medline PY - 2007/5/12/entrez SP - 1846 EP - 51 JF - The Journal of infectious diseases JO - J Infect Dis VL - 195 IS - 12 N2 - BACKGROUND: Pentavalent antimonials (SbV) are the first-line chemotherapy for American tegumentary leishmaniasis (ATL). There are, however, reports of the occurrence of treatment failure with these drugs. Few studies in Latin America have compared the response to SbV treatment in ATL caused by different Leishmania species. METHODS: Clinical parameters and response to SbV chemotherapy were studied in 103 patients with cutaneous leishmaniasis (CL) in Peru. Leishmania isolates were collected before treatment and typed by multilocus polymerase-chain-reaction restriction fragment-length polymorphism analysis. RESULTS: The 103 isolates were identified as L. (Viannia) peruviana (47.6%), L. (V.) guyanensis (23.3%), L. (V.) braziliensis (22.3%), L. (V.) lainsoni (4.9%), L. (Leishmania) mexicana (1%), and a putative hybrid, L. (V.) braziliensis/L. (V.) peruviana (1%). L. (V.) guyanensis was most abundant in central Peru. Of patients infected with the 3 former species, 21 (21.9%) did not respond to SbV chemotherapy. The proportions of treatment failure (after 12 months of follow-up) were 30.4%, 24.5%, and 8.3% in patients infected with L. (V.) braziliensis, L. (V.) peruviana, and L. (V.) guyanensis, respectively. Infection with L. (V.) guyanensis was associated with significantly less treatment failure than L. (V.) braziliensis, as determined by multiple logistic regression analysis (odds ratio, 0.07 [95% confidence interval, 0.007-0.8]; P=.03). CONCLUSIONS: Leishmania species can influence SbV treatment outcome in patients with CL. Therefore, parasite identification is of utmost clinical importance, because it should lead to a species-oriented treatment. SN - 0022-1899 UR - https://www.unboundmedicine.com/medline/citation/17492601/Influence_of_Leishmania__Viannia__species_on_the_response_to_antimonial_treatment_in_patients_with_American_tegumentary_leishmaniasis_ L2 - https://academic.oup.com/jid/article-lookup/doi/10.1086/518041 DB - PRIME DP - Unbound Medicine ER -