Leishmania-HIV Co-infection: Clinical Presentation and Outcomes in an Urban Area in Brazil

Detalhes bibliográficos
Autor(a) principal: Cota, Gláucia Fernandes
Data de Publicação: 2014
Outros Autores: Sousa, Marcos Roberto de, Mendonça, Andrea Laender Pessoa de, Patrocinio, Allan, Assunçao, Luiza Siqueira, Faria, Sidnei Rodrigues de, Rabello, Ana Lucia Teles
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da FIOCRUZ (ARCA)
Texto Completo: https://www.arca.fiocruz.br/handle/icict/9501
Resumo: Fundaçao Oswaldo Cruz. Centro de Pesquisas Rene Rachou. Laboratório de Pesquisas Clinicas. Belo Horizonte, MG, Brasil / Fundação Hospitalar do Estado de Minas Gerais. Hospital Eduardo de Menezes. Belo Horizonte, MG, Brasil.
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spelling Cota, Gláucia FernandesSousa, Marcos Roberto deMendonça, Andrea Laender Pessoa dePatrocinio, AllanAssunçao, Luiza SiqueiraFaria, Sidnei Rodrigues deRabello, Ana Lucia Teles2015-02-19T15:28:58Z2015-02-19T15:28:58Z2014COTA, Gláucia Fernandes et al. Leishmania-HIV Co-infection: Clinical Presentation and Outcomes in an Urban Area in Brazil. PLoS Neglected Tropical Diseases, v. 8, n. 4, p. 1-7, Apr. 2014.1935-2735https://www.arca.fiocruz.br/handle/icict/950110.1371/journal.pntd.0002816engPublic Library of ScienceLeishmania-HIV Co-infection: Clinical Presentation and Outcomes in an Urban Area in Brazilinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleFundaçao Oswaldo Cruz. Centro de Pesquisas Rene Rachou. Laboratório de Pesquisas Clinicas. Belo Horizonte, MG, Brasil / Fundação Hospitalar do Estado de Minas Gerais. Hospital Eduardo de Menezes. Belo Horizonte, MG, Brasil.Universidade Federal de Minas Gerais. Programa de Pós Graduação em Ciências da Saúde. Belo Horizonte, Minas Gerais, Brasil.Fundação Hospitalar do Estado de Minas Gerais. Eduardo de Menezes Hospital. Belo Horizonte, MG, Brasil.Fundação Hospitalar do Estado de Minas Gerais. Eduardo de Menezes Hospital. Belo Horizonte, MG, Brasil.Fundação Hospitalar do Estado de Minas Gerais. Eduardo de Menezes Hospital. Belo Horizonte, MG, Brasil.Fundação Hospitalar do Estado de Minas Gerais. Eduardo de Menezes Hospital. Belo Horizonte, MG, Brasil.Fundação Oswaldo Cruz. Centro de Pesquisas Rene Rachou. Laboratório de Pesquisas Clinicas. Belo Horizonte, MG, Brasil.BACKGROUND: Visceral leishmaniasis (VL) is an emerging condition affecting HIV-infected patients living in Latin America, particularly in Brazil. Leishmania-HIV coinfection represents a challenging diagnosis because the clinical picture of VL is similar to that of other disseminated opportunistic diseases. Additionally, coinfection is related to treatment failure, relapse and high mortality. OBJECTIVE: To assess the clinical-laboratory profile and outcomes of VL-HIV-coinfected patients using a group of non HIV-infected patients diagnosed with VL during the same period as a comparator. METHODS: The study was conducted at a reference center for infectious diseases in Brazil. All patients with suspected VL were evaluated in an ongoing cohort study. Confirmed cases were divided into two groups: with and without HIV coinfection. Patients were treated according to the current guidelines of the Ministry of Health of Brazil, which considers antimony as the first-choice therapy for non HIV-infected patients and recommends amphotericin B for HIV-infected patients. After treatment, all patients with CD4 counts below 350 cells/mm3 received secondary prophylaxis with amphotericin B. RESULTS: Between 2011 and 2013, 168 patients with suspected VL were evaluated, of whom 90 were confirmed to have VL. In total, 51% were HIV coinfected patients (46 patients). HIV-infected patients had a lower rate of fever and splenomegaly compared with immunocompetent patients. The VL relapse rate in 6 months was 37% among HIV-infected patients, despite receiving secondary prophylaxis. The overall case-fatality rate was 6.6% (4 deaths in the HIV-infected group versus 2 deaths in the non HIV-infected group). The main risk factors for a poor outcome at 6 months after the end of treatment were HIV infection, bleeding and a previous VL episode. CONCLUSION: Although VL mortality rates among HIV-infected individuals are close to those observed among immunocompetent patients treated with amphotericin B, HIV coinfection is related to a low clinical response and high relapse rates within 6 months.BrazilCoinfectionCoinfectionLeishmaniasis VisceralHIV InfectionsEpidemiologyComplicationsinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; charset=utf-81914https://www.arca.fiocruz.br/bitstream/icict/9501/1/license.txt7d48279ffeed55da8dfe2f8e81f3b81fMD51ORIGINAL2014_085.pdf2014_085.pdfapplication/pdf219256https://www.arca.fiocruz.br/bitstream/icict/9501/2/2014_085.pdfa2c692be2c14cd0540105f2b7d277261MD52TEXT2014_085.pdf.txt2014_085.pdf.txtExtracted texttext/plain39937https://www.arca.fiocruz.br/bitstream/icict/9501/3/2014_085.pdf.txtec6b4984355d0bcf9e1a6823b4a484f8MD53icict/95012019-12-23 20:12:03.59oai:www.arca.fiocruz.br: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ório InstitucionalPUBhttps://www.arca.fiocruz.br/oai/requestrepositorio.arca@fiocruz.bropendoar:21352019-12-23T23:12:03Repositório Institucional da FIOCRUZ (ARCA) - Fundação Oswaldo Cruz (FIOCRUZ)false
dc.title.pt_BR.fl_str_mv Leishmania-HIV Co-infection: Clinical Presentation and Outcomes in an Urban Area in Brazil
title Leishmania-HIV Co-infection: Clinical Presentation and Outcomes in an Urban Area in Brazil
spellingShingle Leishmania-HIV Co-infection: Clinical Presentation and Outcomes in an Urban Area in Brazil
Cota, Gláucia Fernandes
Brazil
Coinfection
Coinfection
Leishmaniasis Visceral
HIV Infections
Epidemiology
Complications
title_short Leishmania-HIV Co-infection: Clinical Presentation and Outcomes in an Urban Area in Brazil
title_full Leishmania-HIV Co-infection: Clinical Presentation and Outcomes in an Urban Area in Brazil
title_fullStr Leishmania-HIV Co-infection: Clinical Presentation and Outcomes in an Urban Area in Brazil
title_full_unstemmed Leishmania-HIV Co-infection: Clinical Presentation and Outcomes in an Urban Area in Brazil
title_sort Leishmania-HIV Co-infection: Clinical Presentation and Outcomes in an Urban Area in Brazil
author Cota, Gláucia Fernandes
author_facet Cota, Gláucia Fernandes
Sousa, Marcos Roberto de
Mendonça, Andrea Laender Pessoa de
Patrocinio, Allan
Assunçao, Luiza Siqueira
Faria, Sidnei Rodrigues de
Rabello, Ana Lucia Teles
author_role author
author2 Sousa, Marcos Roberto de
Mendonça, Andrea Laender Pessoa de
Patrocinio, Allan
Assunçao, Luiza Siqueira
Faria, Sidnei Rodrigues de
Rabello, Ana Lucia Teles
author2_role author
author
author
author
author
author
dc.contributor.author.fl_str_mv Cota, Gláucia Fernandes
Sousa, Marcos Roberto de
Mendonça, Andrea Laender Pessoa de
Patrocinio, Allan
Assunçao, Luiza Siqueira
Faria, Sidnei Rodrigues de
Rabello, Ana Lucia Teles
dc.subject.en.pt_BR.fl_str_mv Brazil
Coinfection
Coinfection
Leishmaniasis Visceral
HIV Infections
Epidemiology
Complications
topic Brazil
Coinfection
Coinfection
Leishmaniasis Visceral
HIV Infections
Epidemiology
Complications
description Fundaçao Oswaldo Cruz. Centro de Pesquisas Rene Rachou. Laboratório de Pesquisas Clinicas. Belo Horizonte, MG, Brasil / Fundação Hospitalar do Estado de Minas Gerais. Hospital Eduardo de Menezes. Belo Horizonte, MG, Brasil.
publishDate 2014
dc.date.issued.fl_str_mv 2014
dc.date.accessioned.fl_str_mv 2015-02-19T15:28:58Z
dc.date.available.fl_str_mv 2015-02-19T15:28:58Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.citation.fl_str_mv COTA, Gláucia Fernandes et al. Leishmania-HIV Co-infection: Clinical Presentation and Outcomes in an Urban Area in Brazil. PLoS Neglected Tropical Diseases, v. 8, n. 4, p. 1-7, Apr. 2014.
dc.identifier.uri.fl_str_mv https://www.arca.fiocruz.br/handle/icict/9501
dc.identifier.issn.none.fl_str_mv 1935-2735
dc.identifier.doi.none.fl_str_mv 10.1371/journal.pntd.0002816
identifier_str_mv COTA, Gláucia Fernandes et al. Leishmania-HIV Co-infection: Clinical Presentation and Outcomes in an Urban Area in Brazil. PLoS Neglected Tropical Diseases, v. 8, n. 4, p. 1-7, Apr. 2014.
1935-2735
10.1371/journal.pntd.0002816
url https://www.arca.fiocruz.br/handle/icict/9501
dc.language.iso.fl_str_mv eng
language eng
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Public Library of Science
publisher.none.fl_str_mv Public Library of Science
dc.source.none.fl_str_mv reponame:Repositório Institucional da FIOCRUZ (ARCA)
instname:Fundação Oswaldo Cruz (FIOCRUZ)
instacron:FIOCRUZ
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