Efficacy of anti-leishmania therapy in visceral leishmaniasis among HIV infected patients: a systematic review with indirect comparison

Detalhes bibliográficos
Autor(a) principal: Cota, Gláucia Fernandes
Data de Publicação: 2013
Outros Autores: Sousa, Marcos R. de, Fereguetti, Tatiani Oliveira, 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/30428
Resumo: Fundação Oswaldo Cruz. Centro de Pesquisas René Rachou. Laboratório de Pesquisa Clínica. Belo Horizonte, MG, Brazil/Fundação Hospitalar do Estado de Minas Gerais. Hospital Eduardo de Menezes. Belo Horizonte, MG, Brazil
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spelling Cota, Gláucia FernandesSousa, Marcos R. deFereguetti, Tatiani OliveiraRabello, Ana Lucia Teles2018-12-07T18:19:47Z2018-12-07T18:19:47Z2013COTA, Gláucia Fernandes et al. Efficacy of anti-leishmania therapy in visceral leishmaniasis among HIV infected patients: a systematic review with indirect comparison. PLoS Negl Trop Dis., v. 7, n. 5, e2195, 20131935-2735https://www.arca.fiocruz.br/handle/icict/3042810.1371/journal.pntd.0002195engPublic Library of ScienceHIVleishmaniose visceralHIVvisceral leishmaniasisEfficacy of anti-leishmania therapy in visceral leishmaniasis among HIV infected patients: a systematic review with indirect comparisoninfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleFundação Oswaldo Cruz. Centro de Pesquisas René Rachou. Laboratório de Pesquisa Clínica. Belo Horizonte, MG, Brazil/Fundação Hospitalar do Estado de Minas Gerais. Hospital Eduardo de Menezes. Belo Horizonte, MG, BrazilUniversidade Federal de Minas Gerais. Programa de Pós-Graduação em Ciências da Saúde do Adulto. Belo Horizonte, MG, BrazilFundação Hospitalar do Estado de Minas Gerais. Hospital Eduardo de Menezes. Belo Horizonte, MG, BrazilFundação Oswaldo Cruz. Centro de Pesquisas René Rachou. Laboratório de Pesquisa Clínica. Belo Horizonte, MG, BrazilOBJECTIVE: We conducted a systematic literature review with indirect comparison of studies evaluating therapeutic efficacy and toxicity associated to visceral leishmaniasis (VL) therapy among HIV infected individuals. MAIN OUTCOME MEASUREMENTS: The outcomes of interest were clinical and parasitological cure, mortality, and adverse events. METHODS: PRISMA guidelines for systematic reviews and Cochrane manual were followed. Sources were MEDLINE, LILACS, EMBASE, Web of Knowledge databases and manual search of references from evaluated studies. We included all studies reporting outcomes after VL treatment, regardless of their design. Study quality was evaluated systematically by using the Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analyses. Comprehensive Meta-Analysis software v.2.2.048 was used to perform one-group meta-analysis of study arms with the same drug to estimate global rates of success and adverse events with each drug. These estimates were used, when possible, to indirectly compare treatment options, adjusted for CD4 count. Direct comparison was pooled when available. RESULTS: Seventeen studies reporting five treatment regimens and outcome of 920 VL episodes occurring in HIV infected individuals were included. The main outstanding difference in outcome among the treatment regimens was observed in mortality rate: it was around 3 times higher with high-dose antimony use (18.4%, CI 95% 13.3-25%), indirectly compared to lipid formulations of amphotericin B treatment (6.1%, CI 95% 3.9-9.4%). It was observed, also by indirect comparison, higher rates of clinical improvement in study arms using amphotericin B than in study arms using pentavalent antimonial therapy (Sb(v)). The parasitological cure, an outcome that presented some degree of risk of selection and verification bias, had rates that varied widely within the same treatment arm, with high heterogeneity, hampering any formal comparison among drugs. One direct comparison of amphotericin and antimoniate was possible combining results of two studies and confirming the superiority of amphotericin. CONCLUSIONS: Available evidence suggests that amphotericin is superior to antimony treatment. Death rate using antimoniate high dose is unacceptably high. Randomized controlled trials are necessary to compare different formulations and doses of amphotericin, alternative therapies and drug combinations.info:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; charset=utf-82991https://www.arca.fiocruz.br/bitstream/icict/30428/1/license.txt5a560609d32a3863062d77ff32785d58MD51ORIGINALEfficacy of Anti-Leishmania Therapy in Visceral Leishmaniasis .pdfEfficacy of Anti-Leishmania Therapy in Visceral Leishmaniasis .pdfapplication/pdf6977310https://www.arca.fiocruz.br/bitstream/icict/30428/2/Efficacy%20of%20Anti-Leishmania%20Therapy%20in%20Visceral%20Leishmaniasis%20.pdf707f055984679efb9e035128adfd6c6fMD52TEXTEfficacy of Anti-Leishmania Therapy in Visceral Leishmaniasis .pdf.txtEfficacy of Anti-Leishmania Therapy in Visceral Leishmaniasis .pdf.txtExtracted 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dc.title.pt_BR.fl_str_mv Efficacy of anti-leishmania therapy in visceral leishmaniasis among HIV infected patients: a systematic review with indirect comparison
title Efficacy of anti-leishmania therapy in visceral leishmaniasis among HIV infected patients: a systematic review with indirect comparison
spellingShingle Efficacy of anti-leishmania therapy in visceral leishmaniasis among HIV infected patients: a systematic review with indirect comparison
Cota, Gláucia Fernandes
HIV
leishmaniose visceral
HIV
visceral leishmaniasis
title_short Efficacy of anti-leishmania therapy in visceral leishmaniasis among HIV infected patients: a systematic review with indirect comparison
title_full Efficacy of anti-leishmania therapy in visceral leishmaniasis among HIV infected patients: a systematic review with indirect comparison
title_fullStr Efficacy of anti-leishmania therapy in visceral leishmaniasis among HIV infected patients: a systematic review with indirect comparison
title_full_unstemmed Efficacy of anti-leishmania therapy in visceral leishmaniasis among HIV infected patients: a systematic review with indirect comparison
title_sort Efficacy of anti-leishmania therapy in visceral leishmaniasis among HIV infected patients: a systematic review with indirect comparison
author Cota, Gláucia Fernandes
author_facet Cota, Gláucia Fernandes
Sousa, Marcos R. de
Fereguetti, Tatiani Oliveira
Rabello, Ana Lucia Teles
author_role author
author2 Sousa, Marcos R. de
Fereguetti, Tatiani Oliveira
Rabello, Ana Lucia Teles
author2_role author
author
author
dc.contributor.author.fl_str_mv Cota, Gláucia Fernandes
Sousa, Marcos R. de
Fereguetti, Tatiani Oliveira
Rabello, Ana Lucia Teles
dc.subject.other.pt_BR.fl_str_mv HIV
leishmaniose visceral
topic HIV
leishmaniose visceral
HIV
visceral leishmaniasis
dc.subject.en.pt_BR.fl_str_mv HIV
visceral leishmaniasis
description Fundação Oswaldo Cruz. Centro de Pesquisas René Rachou. Laboratório de Pesquisa Clínica. Belo Horizonte, MG, Brazil/Fundação Hospitalar do Estado de Minas Gerais. Hospital Eduardo de Menezes. Belo Horizonte, MG, Brazil
publishDate 2013
dc.date.issued.fl_str_mv 2013
dc.date.accessioned.fl_str_mv 2018-12-07T18:19:47Z
dc.date.available.fl_str_mv 2018-12-07T18:19:47Z
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. Efficacy of anti-leishmania therapy in visceral leishmaniasis among HIV infected patients: a systematic review with indirect comparison. PLoS Negl Trop Dis., v. 7, n. 5, e2195, 2013
dc.identifier.uri.fl_str_mv https://www.arca.fiocruz.br/handle/icict/30428
dc.identifier.issn.pt_BR.fl_str_mv 1935-2735
dc.identifier.doi.none.fl_str_mv 10.1371/journal.pntd.0002195
identifier_str_mv COTA, Gláucia Fernandes et al. Efficacy of anti-leishmania therapy in visceral leishmaniasis among HIV infected patients: a systematic review with indirect comparison. PLoS Negl Trop Dis., v. 7, n. 5, e2195, 2013
1935-2735
10.1371/journal.pntd.0002195
url https://www.arca.fiocruz.br/handle/icict/30428
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)
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instname_str Fundação Oswaldo Cruz (FIOCRUZ)
instacron_str FIOCRUZ
institution FIOCRUZ
reponame_str Repositório Institucional da FIOCRUZ (ARCA)
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