Response to treatment for visceral leishmaniasis in patients coinfected by Leishmania/HIV

• Autor(a) principal: Barreto, Marianny da Silva
• Data de Publicação: 2023
• Outros Autores: Paulino, Ana Leticia Lira, Vieira, Maria Clara Sousa Evangelista, BACHUR, TATIANA PASCHOALETTE RODRIGUES
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Revista Brasileira de Educação e Saúde
• Texto Completo: https://www.gvaa.com.br/revista/index.php/REBES/article/view/9827

Visceral Leishmaniasis (VL) in patients immunosuppressed by the human immunodeficiency virus (HIV) is usually a severe opportunistic disease. The management of VL in people living with HIV (PLHIV) is challenging, since these patients have a poor response to antileishmania treatment, with a risk of chronic evolution and a high rate of VL recurrence. This study aims to describe the response to anti-leishmania treatment in patients co-infected with Leishmania/HIV, highlighting the factors that hinder the proper management of VL and the treatment alternatives capable of improving the response of these patients to anti-leishmania therapy. This is a bibliographical research conducted in the MEDLINE, LILACS, EMBASE, SCOPUS and SCIENCE DIRECT databases, including articles published between 2017 and 2023, with themes relevant to the object of study, with 16 studies being selected to be discussed. Studies point out that the main factors associated with poor response to VL treatment in PLHIV are the difficulty in achieving the appropriate concentration of antileishmania drugs in the body of these patients, lack of secondary prophylaxis, lack of effective antiretroviral therapy (ART), previous relapse VL, low immunity, co-infection with tuberculosis and poor nutritional status. The administration of antileishmanial drugs in a combined regimen instead of monotherapy, together with the early initiation of ART and the institution of secondary prophylaxis can improve the outcome of VL in patients co-infected with Leishmania/HIV. However, effective treatment for VL in these patients is still a challenge, and it is necessary to find more effective ways to improve therapeutic response. Key words: Visceral leishmaniasis. HIV infection. Antileishmania treatment. Combination therapy.