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Combination treatment for visceral leishmaniasis patients coinfected with human immunodeficiency virus in India

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dc.contributor.author Mahajan, R. en_US
dc.contributor.author Das, P. en_US
dc.contributor.author Isaakidis, P. en_US
dc.contributor.author Sunyoto, T. en_US
dc.contributor.author Sagili, K. D. en_US
dc.contributor.author Lima, M. A. en_US
dc.contributor.author Mitra, G. en_US
dc.contributor.author Kumar, D. en_US
dc.contributor.author Pandey, K. en_US
dc.contributor.author Van geertruyden, J. P. en_US
dc.contributor.author Boelaert, M. en_US
dc.contributor.author Burza, S. en_US
dc.date.accessioned 2017-12-18T12:56:11Z
dc.date.available 2017-12-18T12:56:11Z
dc.date.issued 2015 en_US
dc.identifier.issn 1058-4838 en_US
dc.identifier.doi http://dx.doi.org/10.1093/cid/civ530 en_US
dc.identifier.other http://lib.itg.be/pdf/itg/2016/2016cidi1255.pdf en_US
dc.identifier.other 22 en_US
dc.identifier.other ITG-H11A; DPH; U-ECTD; JIF; DOI; PDF; PMC; Abstract; DSPACE64 en_US
dc.identifier.uri http://hdl.handle.net/10390/9945
dc.description.abstract BACKGROUND: There are considerable numbers of patients coinfected with human immunodeficiency virus (HIV) and visceral leishmaniasis (VL) in the VL-endemic areas of Bihar, India. These patients are at higher risk of relapse and death, but there are still no evidence-based guidelines on how to treat them. In this study, we report on treatment outcomes of coinfected patients up to 18 months following treatment with a combination regimen. METHODS: This retrospective analysis included all patients with confirmed HIV-VL coinfection receiving combination treatment for VL at a Medecins Sans Frontieres treatment center between July 2012 and September 2014. Patients were treated with 30 mg/kg body weight intravenous liposomal amphotericin B (AmBisome) divided as 6 equal dose infusions combined with 14 days of 100 mg/day oral miltefosine (Impavido). All patients were encouraged to start or continue on antiretroviral therapy (ART). RESULTS: 102 patients (76% males, 57% with known HIV infection, 54% with a prior episode of VL) were followed-up for a median of 11 months (interquartile range: 4-18). Cumulative incidence of all-cause mortality and VL relapse at 6, 12, and 18 months was 11.7%, 14.5%, 16.6% and 2.5%, 6.0%,13.9%, respectively. Cumulative incidence of poor outcome at 6, 12, and 18 months was 13.9%, 18.4%, and 27.2%, respectively. Not initiating ART and concurrent tuberculosis were independent risk factors for mortality, whereas no factors were associated with relapse. CONCLUSIONS: In this Bihar-based study, combination therapy appeared to be well tolerated, safe, and effective and may be considered as an option for treatment of VL in HIV coinfected patients. en_US
dc.language English en_US
dc.publisher Clinical Infectious Diseases en_US
dc.relation.uri http://www.ncbi.nlm.nih.gov/pubmed/26129756 en_US
dc.subject Leishmaniasis en_US
dc.subject Visceral en_US
dc.subject Protozoal diseases en_US
dc.subject HIV en_US
dc.subject Viral diseases en_US
dc.subject Co-infections en_US
dc.subject Treatment en_US
dc.subject India en_US
dc.subject Asia-South en_US
dc.title Combination treatment for visceral leishmaniasis patients coinfected with human immunodeficiency virus in India en_US
dc.type Article en_US
dc.citation.issue 8 en_US
dc.citation.volume 61 en_US
dc.citation.pages 1255 en_US
dc.citation.abbreviation Clin Infect Dis en_US


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