Long term outcomes and prognostics of visceral leishmaniasis in HIV infected patients with use of pentamidine as secondary prophylaxis based on CD4 level: a prospective cohort study in Ethiopia

PLoS Neglected Tropical Diseases
Ermias DiroSéverine Blesson

Abstract

The long-term treatment outcome of visceral leishmaniasis (VL) patients with HIV co-infection is complicated by a high rate of relapse, especially when the CD4 count is low. Although use of secondary prophylaxis is recommended, it is not routinely practiced and data on its effectiveness and safety are limited. A prospective cohort study was conducted in Northwest Ethiopia from August 2014 to August 2017 (NCT02011958). HIV-VL patients were followed for up to 12 months. Patients with CD4 cell counts below 200/μL at the end of VL treatment received pentamidine prophylaxis starting one month after parasitological cure, while those with CD4 count ≥200 cells/μL were followed without secondary prophylaxis. Compliance, safety and relapse-free survival, using Kaplan-Meier analysis methods to account for variable time at risk, were summarised. Risk factors for relapse or death were analysed. Fifty-four HIV patients were followed. The probability of relapse-free survival at one year was 50% (95% confidence interval [CI]: 35-63%): 53% (30-71%) in 22 patients with CD4 ≥200 cells/μL without pentamidine prophylaxis and 46% (26-63%) in 29 with CD4 <200 cells/μL who started pentamidine. Three patients with CD4 <200 cells/μL did not start pentam...Continue Reading

References

May 1, 1996·The American Journal of Medicine·E RiberaA Pahissa
Mar 12, 1998·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·F LagunaJ M González-Lahoz
May 29, 2002·Tropical Medicine & International Health : TM & IH·Gundel Harms, Hermann Feldmeier
Jul 10, 2003·The Journal of Infection·J DereureJ P Dedet
Jan 24, 2004·The Journal of Antimicrobial Chemotherapy·Rogelio López-VélezUNKNOWN Spanish HIV-Leishmania Study Group
Apr 11, 2008·Clinical Microbiology Reviews·Jorge AlvarJavier Moreno
Apr 19, 2008·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Rachel ter HorstRobert N Davidson
May 30, 2008·PLoS Neglected Tropical Diseases·Thomas P C Dorlo, Piet A Kager
Jun 26, 2009·Tropical Medicine & International Health : TM & IH·T A Patel, D N Lockwood
Jul 8, 2010·Journal of Global Infectious Diseases·Jaya Chakravarty, Shyam Sundar
Oct 22, 2011·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Koert RitmeijerRobert N Davidson
Feb 19, 2013·Advances in Applied Microbiology·Gaurav GuptaAbhay R Satoskar
Oct 12, 2017·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Ermias DiroJohan van Griensven
May 11, 2018·PLoS Neglected Tropical Diseases·Hannah AkuffoMercè Herrero

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Citations

Sep 3, 2020·Applied Microbiology and Biotechnology·Bruno Mendes RoattAlexandre Barbosa Reis
Jun 16, 2021·Revista iberoamericana de micología·Begoña Monge-Maillo, Rogelio López-Vélez
Jul 1, 2021·Research and Reports in Tropical Medicine·Grace GriffertyRichard Wamai

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NCT02011958

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