Tags

Type your tag names separated by a space and hit enter

High parasitological failure rate of visceral leishmaniasis to sodium stibogluconate among HIV co-infected adults in Ethiopia.
PLoS Negl Trop Dis. 2014 May; 8(5):e2875.PN

Abstract

BACKGROUND

Antimonials are still being used for visceral leishmaniasis (VL) treatment among HIV co-infected patients in East-Africa due to the shortage of alternative safer drugs like liposomal amphotericin B. Besides tolerability, emergence of resistance to antimonials is a major concern.

OBJECTIVES

This study was aimed at assessing the clinical outcome of VL-HIV co-infected patients when treated with sodium stibogluconate (SSG).

METHODS

Retrospective patient record analysis of VL-HIV co-infected patients treated at a clinical trial site in north-west Ethiopia was done. Patients with parasitologically confirmed VL and HIV co-infection treated with SSG were included. The dose of SSG used was 20 mg Sb5 (pentavalent antimony)/kg and maximum of 850 mg Sb5 for 30 days. The clinical outcomes were defined based on the tissue aspiration results as cure or failure, and additionally the safety and mortality rates were computed.

RESULTS

The study included 57 patients treated with SSG and by the end of treatment only 43.9% of patients were cured. The parasitological treatment failure and the case fatality rate were 31.6% and 14.0% respectively. SSG was discontinued temporarily or permanently for 12 (21.1%) cases due to safety issues. High baseline parasite load (graded more than 4+) was significantly associated with treatment failure (odds ratio = 8.9, 95% confidence interval = .5-51.7).

CONCLUSION

SSG is not only unsafe, but also has low effectiveness for VL-HIV patients. Safe and effective alternative medications are very urgently needed. Drug sensitivity surveillance should be introduced in the region.

Authors+Show Affiliations

University of Gondar, Gondar, Ethiopia; Institute of Tropical Medicine, Antwerp, Belgium.Institute of Tropical Medicine, Antwerp, Belgium.University of Gondar, Gondar, Ethiopia.Institute of Tropical Medicine, Antwerp, Belgium.Addis Ababa University School of Medicine, Addis Ababa, Ethiopia.Institute of Tropical Medicine, Antwerp, Belgium.

Pub Type(s)

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

Language

eng

PubMed ID

24854196

Citation

Diro, Ermias, et al. "High Parasitological Failure Rate of Visceral Leishmaniasis to Sodium Stibogluconate Among HIV Co-infected Adults in Ethiopia." PLoS Neglected Tropical Diseases, vol. 8, no. 5, 2014, pp. e2875.
Diro E, Lynen L, Mohammed R, et al. High parasitological failure rate of visceral leishmaniasis to sodium stibogluconate among HIV co-infected adults in Ethiopia. PLoS Negl Trop Dis. 2014;8(5):e2875.
Diro, E., Lynen, L., Mohammed, R., Boelaert, M., Hailu, A., & van Griensven, J. (2014). High parasitological failure rate of visceral leishmaniasis to sodium stibogluconate among HIV co-infected adults in Ethiopia. PLoS Neglected Tropical Diseases, 8(5), e2875. https://doi.org/10.1371/journal.pntd.0002875
Diro E, et al. High Parasitological Failure Rate of Visceral Leishmaniasis to Sodium Stibogluconate Among HIV Co-infected Adults in Ethiopia. PLoS Negl Trop Dis. 2014;8(5):e2875. PubMed PMID: 24854196.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - High parasitological failure rate of visceral leishmaniasis to sodium stibogluconate among HIV co-infected adults in Ethiopia. AU - Diro,Ermias, AU - Lynen,Lutgarde, AU - Mohammed,Rezika, AU - Boelaert,Marleen, AU - Hailu,Asrat, AU - van Griensven,Johan, Y1 - 2014/05/22/ PY - 2013/12/31/received PY - 2014/04/04/accepted PY - 2014/5/24/entrez PY - 2014/5/24/pubmed PY - 2015/6/2/medline SP - e2875 EP - e2875 JF - PLoS neglected tropical diseases JO - PLoS Negl Trop Dis VL - 8 IS - 5 N2 - BACKGROUND: Antimonials are still being used for visceral leishmaniasis (VL) treatment among HIV co-infected patients in East-Africa due to the shortage of alternative safer drugs like liposomal amphotericin B. Besides tolerability, emergence of resistance to antimonials is a major concern. OBJECTIVES: This study was aimed at assessing the clinical outcome of VL-HIV co-infected patients when treated with sodium stibogluconate (SSG). METHODS: Retrospective patient record analysis of VL-HIV co-infected patients treated at a clinical trial site in north-west Ethiopia was done. Patients with parasitologically confirmed VL and HIV co-infection treated with SSG were included. The dose of SSG used was 20 mg Sb5 (pentavalent antimony)/kg and maximum of 850 mg Sb5 for 30 days. The clinical outcomes were defined based on the tissue aspiration results as cure or failure, and additionally the safety and mortality rates were computed. RESULTS: The study included 57 patients treated with SSG and by the end of treatment only 43.9% of patients were cured. The parasitological treatment failure and the case fatality rate were 31.6% and 14.0% respectively. SSG was discontinued temporarily or permanently for 12 (21.1%) cases due to safety issues. High baseline parasite load (graded more than 4+) was significantly associated with treatment failure (odds ratio = 8.9, 95% confidence interval = .5-51.7). CONCLUSION: SSG is not only unsafe, but also has low effectiveness for VL-HIV patients. Safe and effective alternative medications are very urgently needed. Drug sensitivity surveillance should be introduced in the region. SN - 1935-2735 UR - https://www.unboundmedicine.com/medline/citation/24854196/High_parasitological_failure_rate_of_visceral_leishmaniasis_to_sodium_stibogluconate_among_HIV_co_infected_adults_in_Ethiopia_ DB - PRIME DP - Unbound Medicine ER -