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Parasite susceptibility to amphotericin B in failures of treatment for visceral leishmaniasis in patients coinfected with HIV type 1 and Leishmania infantum.
Clin Infect Dis. 2009 Jan 15; 48(2):e16-22.CI

Abstract

BACKGROUND

Visceral leishmaniasis (VL) is an opportunistic infection that can occur among patients infected with human immunodeficiency virus type 1 (HIV-1) in areas where both infections are endemic. Highly active antiretroviral therapy has decreased the incidence of VL in southern Europe among HIV-1-infected patients, but VL is still observed among patients with low CD4 cell counts, and most coinfected patients receiving highly active antiretroviral therapy experienced relapse, despite initial treatment with liposomal amphotericin B.

METHODS

Through long-term monitoring of VL in 10 patients with HIV-1 infection and/or AIDS, we compared parasite strains derived from primary and secondary episodes of VL. All the patients have received many courses of amphotericin B treatment and/or prophylaxis.

RESULTS

Through molecular techniques, we have shown that secondary episodes of VL can be attributable to relapse (7 of 10 episodes) or reinfection (3 of 10). We developed an assay to measure amphotericin B susceptibility and found no evidence of decreased susceptibility among strains isolated from patients, some of whom were infected with the same isolate for up to 10 years.

CONCLUSIONS

This apparent absence of resistance, as determined by in vitro susceptibility testing, has important consequences and suggests that amphotericin B will remain a useful drug of choice against VL, even after repetitive treatments or prophylactic use.

Authors+Show Affiliations

Centre de Recherche en Infectiologie and Division de Microbiologie, Faculté de Médecine, Université Laval, Quebec, Canada.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19093811

Citation

Lachaud, Laurence, et al. "Parasite Susceptibility to Amphotericin B in Failures of Treatment for Visceral Leishmaniasis in Patients Coinfected With HIV Type 1 and Leishmania Infantum." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 48, no. 2, 2009, pp. e16-22.
Lachaud L, Bourgeois N, Plourde M, et al. Parasite susceptibility to amphotericin B in failures of treatment for visceral leishmaniasis in patients coinfected with HIV type 1 and Leishmania infantum. Clin Infect Dis. 2009;48(2):e16-22.
Lachaud, L., Bourgeois, N., Plourde, M., Leprohon, P., Bastien, P., & Ouellette, M. (2009). Parasite susceptibility to amphotericin B in failures of treatment for visceral leishmaniasis in patients coinfected with HIV type 1 and Leishmania infantum. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 48(2), e16-22. https://doi.org/10.1086/595710
Lachaud L, et al. Parasite Susceptibility to Amphotericin B in Failures of Treatment for Visceral Leishmaniasis in Patients Coinfected With HIV Type 1 and Leishmania Infantum. Clin Infect Dis. 2009 Jan 15;48(2):e16-22. PubMed PMID: 19093811.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Parasite susceptibility to amphotericin B in failures of treatment for visceral leishmaniasis in patients coinfected with HIV type 1 and Leishmania infantum. AU - Lachaud,Laurence, AU - Bourgeois,Nathalie, AU - Plourde,Marie, AU - Leprohon,Philippe, AU - Bastien,Patrick, AU - Ouellette,Marc, PY - 2008/12/20/entrez PY - 2008/12/20/pubmed PY - 2009/1/24/medline SP - e16 EP - 22 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 48 IS - 2 N2 - BACKGROUND: Visceral leishmaniasis (VL) is an opportunistic infection that can occur among patients infected with human immunodeficiency virus type 1 (HIV-1) in areas where both infections are endemic. Highly active antiretroviral therapy has decreased the incidence of VL in southern Europe among HIV-1-infected patients, but VL is still observed among patients with low CD4 cell counts, and most coinfected patients receiving highly active antiretroviral therapy experienced relapse, despite initial treatment with liposomal amphotericin B. METHODS: Through long-term monitoring of VL in 10 patients with HIV-1 infection and/or AIDS, we compared parasite strains derived from primary and secondary episodes of VL. All the patients have received many courses of amphotericin B treatment and/or prophylaxis. RESULTS: Through molecular techniques, we have shown that secondary episodes of VL can be attributable to relapse (7 of 10 episodes) or reinfection (3 of 10). We developed an assay to measure amphotericin B susceptibility and found no evidence of decreased susceptibility among strains isolated from patients, some of whom were infected with the same isolate for up to 10 years. CONCLUSIONS: This apparent absence of resistance, as determined by in vitro susceptibility testing, has important consequences and suggests that amphotericin B will remain a useful drug of choice against VL, even after repetitive treatments or prophylactic use. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/19093811/Parasite_susceptibility_to_amphotericin_B_in_failures_of_treatment_for_visceral_leishmaniasis_in_patients_coinfected_with_HIV_type_1_and_Leishmania_infantum_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1086/595710 DB - PRIME DP - Unbound Medicine ER -