| Full text | |
| Author(s): |
Lauletta Lindoso, Jose Angelo
[1, 2, 3]
;
Valente Moreira, Carlos Henrique
[1, 4]
;
Cunha, Mirella Alves
[5]
;
Queiroz, Igor Thiago
[6, 7]
Total Authors: 4
|
| Affiliation: | [1] Inst Infectol Emilio Ribas, Ave Dr Arnaldo 165, BR-01246000 Sao Paulo - Brazil
[2] Univ Brasilia, Nucleo Med Trop, Brasilia, DF - Brazil
[3] Univ Sao Paulo, Inst Med Trop, Lab Soroepidemiol, Sao Paulo - Brazil
[4] Univ Sao Paulo, Inst Med Trop, Lab Parasitol, Sao Paulo - Brazil
[5] Univ Fed Rio Grande do Norte, Dept Infectol, Natal, RN - Brazil
[6] Laureate Int Univ, Univ Potiguar UnP, Natal, RN - Brazil
[7] Hosp Giselda Trigueiro SESAP RN, Natal, RN - Brazil
Total Affiliations: 7
|
| Document type: | Review article |
| Source: | HIV AIDS-RESEARCH AND PALLIATIVE CARE; v. 10, p. 193-201, 2018. |
| Web of Science Citations: | 2 |
| Abstract | |
Visceral leishmaniasis (VL) is caused by Leishmania donovani and Leishmania infantum. The burden of VL is concentrated in tropical and subtropical areas; however, HIV infection has spread VL over a hyperendemic area. Several outcomes are observed as a result of VL-HIV coinfection. Impacts are observed in immunopathogenesis, clinical manifestation, diagnosis, and therapeutic response. Concerning clinical manifestation, typical and unusual manifestation has been observed during active VL in HIV-infected patient, as well as alteration in immunoresponse, inducing greater immunosuppression by low CD4 T-lymphocyte count or even by induction of immunoactivation, with cell senescence. Serological diagnosis of VL in the HIV-infected is poor, due to low humoral response, characterized by antibody production, so parasitological methods are more recommended. Another important and even more challenging point is the definition of the best therapeutic regimen for VL in HIV-coinfected patients, because in this population there is greater failure and consequently higher mortality. The challenge of better understanding immunopathogenesis in order to obtain more effective therapies is one of the crucial points to be developed. The combination of drugs and the use of secondary prophylaxis associated with highly active antiretroviral therapy may be the best tool for treatment of HIV coinfection. Some derivatives from natural sources have action against Leishmania; however, studies have been limited to in vitro evaluation, without clinical trials. (AU) | |
| FAPESP's process: | 16/03165-9 - Coinfection Leishmania/HIV-AIDS: Evaluation of prevalence of coinfection and analysis of genotype from Leishmania (Leishmania) infantum chagasi. |
| Grantee: | José Angelo Lauletta Lindoso |
| Support Opportunities: | Regular Research Grants |