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Memórias do Instituto Oswaldo Cruz
Fundação Oswaldo Cruz, Fiocruz
ISSN: 1678-8060
EISSN: 1678-8060
Vol. 105, No. 5, 2010, pp. 692-697
Bioline Code: oc10117
Full paper language: English
Document type: Research Article
Document available free of charge

Memórias do Instituto Oswaldo Cruz, Vol. 105, No. 5, 2010, pp. 692-697

 en HIV/AIDS-associated visceral leishmaniasis in patients from an endemic area in Central-west Brazil
Alexandrino-de-Oliveira, Priscilla; Santos-Oliveira, Joanna Reis; Dorval, Maria Elizabeth Cavalheiros; Da-Costa, Francisco das Chagas Brandão; Pereira, Gracy Regina Oliveira Leite; da Cunha, Rivaldo Venâncio; Paniago, Anamaria Mello Miranda & Da-Cruz, Alda Maria

Abstract

An increase in morbidity associated with visceral leishmaniasis (VL) in human immunodeficiency virus (HIV)/AIDS patients has been described in Africa and the Mediterranean. Despite the high endemicity of VL and HIV-1/AIDS in Brazil, this association has not been thoroughly investigated. Our aim was to evaluate the epidemiologic and clinical characteristics of VL-HIV-1/AIDS cases from Central-west [Mato Grosso do Sul (MS)] Brazil. Medical records of 23 VL-HIV-1/AIDS patients were reviewed. Patients were predominantly adult males (87%) and 34.8% of the patients were intravenous drug users (IVDU). Leishmaniasis was the first opportunistic infection in 60% of the HIV-1 patients. Fever occurred in all patients, although splenomegaly and hepatomegaly were absent in 21.7% of the cases. CD4+ T-cell counts were below 200 cells/mm3 in 80% of the cases and the counts did not increase after clinical remission despite antiretroviral therapy. The first drug chosen to treat the cases was antimonial, but the therapeutic regimen was altered to amphotericin B in 12 of 17 cases due to side effects. Relapses were reported in 56.5% of the patients. IVDU may constitute an important risk factor for the transmission of both diseases in MS. VL-HIV-1/AIDS patients in MS share similar clinical characteristics as those from other endemic regions worldwide. Thus, these findings are critical for improving the surveillance of VL-HIV/AIDS patients.

Keywords
HIV/AIDS - opportunistic infection - Brazil - visceral leishmaniasis - intravenous drug users - recurrence

 
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