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Visceral leishmaniasis

About: Visceral leishmaniasis is a research topic. Over the lifetime, 7486 publications have been published within this topic receiving 184865 citations. The topic is also known as: Kala-Azar & viscus leishmaniasis.


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Journal ArticleDOI
TL;DR: V visceral leishmaniasis is a very prevalent disease among HIV-1-infected patients in southern Spain, with a high proportion of cases being subclinical, and there is also an association of this disease with male sex and intravenous drug use.
Abstract: The actual prevalence of visceral leishmaniasis among human immunodeficiency type 1 (HIV-1)-infected patients in the Mediterranean basin remains unknown. There is also controversy about the risk factors for Leishmania infantum and HIV-1 coinfection. To appraise the prevalence of visceral leishmaniasis in patients infected with HIV-1 in southern Spain and to identify factors associated with this disease, 291 HIV-1 carriers underwent a bone marrow aspiration, regardless of their symptoms. Giemsa-stained samples were searched for Leishmania amastigotes. Thirty-two (11%) patients showed visceral leishmaniasis. Thirteen (41%) patients had subclinical cases of infection. Centers for Disease Control and Prevention (CDC) clinical category C was the factor most strongly associated with this disease (adjusted odds ratio [OR], 1.88 [95% confidence interval, 1.22 to 2.88]), but patients with subclinical cases of infection were found in all CDC categories. Female sex was negatively associated with visceral leishmaniasis (adjusted OR, 0.42 [95% confidence interval, 0.18 to 0.97]). Intravenous drug users showed a higher prevalence than the remaining patients (13.3 versus 4.9%; P = 0.04), but such an association was not independent. These results show that visceral leishmaniasis is a very prevalent disease among HIV-1-infected patients in southern Spain, with a high proportion of cases being subclinical. Like other opportunistic infections, subclinical visceral leishmaniasis can be found at any stage of HIV-1 infection, but symptomatic cases of infection appear mainly when a deep immunosuppression is present. There is also an association of this disease with male sex and intravenous drug use.

68 citations

Journal ArticleDOI
TL;DR: Whether or not miltefosine can be used for widespread out-patient treatment of individuals and whole populations depends on whether its efficacy and tolerability can be maintained in further treatment trials.
Abstract: Leishmaniasis exists in both visceral and cutaneous forms, and miltefosine is the first oral agent with demonstrable efficacy against both types of this disease At a dose of approximately 25 mg/kg/day for 28 days, miltefosine is > 90% curative for visceral disease in India and cutaneous disease in Colombia Miltefosine is a lecithin analogue and its mechanism may be to inhibit phosphatidylcholine biosynthesis in the causative parasites The clinical half-life of miltefosine is approximately 7 days Whether or not miltefosine can be used for widespread out-patient treatment of individuals and whole populations depends on whether its efficacy and tolerability can be maintained in further treatment trials

68 citations

Journal ArticleDOI
TL;DR: The existence of transplacental transmission of Leishmania between dogs is confirmed by PCR and immunohistochemistry techniques in samples from spleen and liver of two stillborn pups from a bitch naturally infected with L. infantum in Belo Horizonte city, endemic area of VL.

68 citations

Journal ArticleDOI
TL;DR: Global proteome differences between antimony-susceptible/-resistant isolates are identified and modification of expression of proteins involved in the key metabolic pathways are detected, which could serve as surrogate markers for resistance or susceptibility and help in understanding the underlying mechanism of resistance to antimonials.

68 citations

Journal Article
TL;DR: Quantitative polymerase chain reaction (qPCR) has been shown to be superior than conventional PCR for the differentiation between active VL and asymptomatic infections, such as for the detection of VL-HIV coinfection.
Abstract: Visceral leishmaniasis (VL), caused by the Leishmania donovani complex, is a vector-borne systemic disease, with a worldwide distribution causing high morbidity and mortality in the developing world. VL patients may be asymptomatic or they may present symptoms and findings of a systemic infection. The positive predictive value of clinical diagnosis in patients with typical symptoms is usually high, but more often, the signs and symptoms are inconclusive and mistaken with other co-endemic diseases. The fact that HIV co-infections often produce atypical presentations and the heterogeneity of Leishmania species, which is common in many endemic regions, also complicate the diagnosis. Despite that, some of the parasitological methods are still considered to be the reference standard for VL diagnosis due to their specificity. The development of serological and molecular tests has further enhanced the diagnostic approach of VL. Recombinant antigens have improved the performance of serodiagnostic tests, with DAT and the rK39 antigen based immunochromatographic test being the most appropriate methods for the serological diagnosis of VL. Molecular techniques, despite the fact that their implementation is often difficult and infeasible, have become increasingly relevant due to remarkable sensitivity and specificity, and to the variability of tested samples. Quantitative polymerase chain reaction (qPCR) has been shown to be superior than conventional PCR for the differentiation between active VL and asymptomatic infections, such as for the detection of VL-HIV coinfection. This review summarizes the available methods with their applications in the diagnosis of VL, and focuses on the recent developments in VL diagnostics.

68 citations


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Performance
Metrics
No. of papers in the topic in previous years
YearPapers
2023192
2022442
2021269
2020285
2019286
2018253