Predictors of visceral leishmaniasis relapse in HIV-infected patients: a systematic review.
BACKGROUND AND OBJECTIVES: Visceral leishmaniasis (VL) is a common complication in AIDS patients living in Leishmania-endemic areas. Although antiretroviral therapy has changed the clinical course of HIV infection and its associated illnesses, the prevention of VL relapses remains a challenge for th...
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ftdoajarticles:oai:doaj.org/article:becad62a8af44f6894349790ff6d7a2f 2023-05-15T15:15:55+02:00 Predictors of visceral leishmaniasis relapse in HIV-infected patients: a systematic review. Gláucia F Cota Marcos R de Sousa Ana Rabello 2011-06-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0001153 https://doaj.org/article/becad62a8af44f6894349790ff6d7a2f EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC3110161?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0001153 https://doaj.org/article/becad62a8af44f6894349790ff6d7a2f PLoS Neglected Tropical Diseases, Vol 5, Iss 6, p e1153 (2011) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2011 ftdoajarticles https://doi.org/10.1371/journal.pntd.0001153 2022-12-31T15:01:22Z BACKGROUND AND OBJECTIVES: Visceral leishmaniasis (VL) is a common complication in AIDS patients living in Leishmania-endemic areas. Although antiretroviral therapy has changed the clinical course of HIV infection and its associated illnesses, the prevention of VL relapses remains a challenge for the care of HIV and Leishmania co-infected patients. This work is a systematic review of previous studies that have described predictors of VL relapse in HIV-infected patients. REVIEW METHODS: We searched the electronic databases of MEDLINE, LILACS, and the Cochrane Central Register of Controlled Trials. Studies were selected if they included HIV-infected individuals with a VL diagnosis and patient follow-up after the leishmaniasis treatment with an analysis of the clearly defined outcome of prediction of relapse. RESULTS: Eighteen out 178 studies satisfied the specified inclusion criteria. Most patients were males between 30 and 40 years of age, and HIV transmission was primarily via intravenous drug use. Previous VL episodes were identified as risk factors for relapse in 3 studies. Two studies found that baseline CD4+ T cell count above 100 cells/mL was associated with a decreased relapse rate. The observation of an increase in CD4+ T cells at patient follow-up was associated with protection from relapse in 5 of 7 studies. Meta-analysis of all studies assessing secondary prophylaxis showed significant reduction of VL relapse rate following prophylaxis. None of the five observational studies evaluating the impact of highly active antiretroviral therapy use found a reduction in the risk of VL relapse upon patient follow-up. CONCLUSION: SOME PREDICTORS OF VL RELAPSE COULD BE IDENTIFIED: a) the absence of an increase in CD4+ cells at follow-up; b) lack of secondary prophylaxis; and c) previous history of VL relapse. CD4+ counts below 100 cells/mL at the time of primary VL diagnosis may also be a predictive factor for VL relapse. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLoS Neglected Tropical Diseases 5 6 e1153 |
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Directory of Open Access Journals: DOAJ Articles |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Gláucia F Cota Marcos R de Sousa Ana Rabello Predictors of visceral leishmaniasis relapse in HIV-infected patients: a systematic review. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
BACKGROUND AND OBJECTIVES: Visceral leishmaniasis (VL) is a common complication in AIDS patients living in Leishmania-endemic areas. Although antiretroviral therapy has changed the clinical course of HIV infection and its associated illnesses, the prevention of VL relapses remains a challenge for the care of HIV and Leishmania co-infected patients. This work is a systematic review of previous studies that have described predictors of VL relapse in HIV-infected patients. REVIEW METHODS: We searched the electronic databases of MEDLINE, LILACS, and the Cochrane Central Register of Controlled Trials. Studies were selected if they included HIV-infected individuals with a VL diagnosis and patient follow-up after the leishmaniasis treatment with an analysis of the clearly defined outcome of prediction of relapse. RESULTS: Eighteen out 178 studies satisfied the specified inclusion criteria. Most patients were males between 30 and 40 years of age, and HIV transmission was primarily via intravenous drug use. Previous VL episodes were identified as risk factors for relapse in 3 studies. Two studies found that baseline CD4+ T cell count above 100 cells/mL was associated with a decreased relapse rate. The observation of an increase in CD4+ T cells at patient follow-up was associated with protection from relapse in 5 of 7 studies. Meta-analysis of all studies assessing secondary prophylaxis showed significant reduction of VL relapse rate following prophylaxis. None of the five observational studies evaluating the impact of highly active antiretroviral therapy use found a reduction in the risk of VL relapse upon patient follow-up. CONCLUSION: SOME PREDICTORS OF VL RELAPSE COULD BE IDENTIFIED: a) the absence of an increase in CD4+ cells at follow-up; b) lack of secondary prophylaxis; and c) previous history of VL relapse. CD4+ counts below 100 cells/mL at the time of primary VL diagnosis may also be a predictive factor for VL relapse. |
format |
Article in Journal/Newspaper |
author |
Gláucia F Cota Marcos R de Sousa Ana Rabello |
author_facet |
Gláucia F Cota Marcos R de Sousa Ana Rabello |
author_sort |
Gláucia F Cota |
title |
Predictors of visceral leishmaniasis relapse in HIV-infected patients: a systematic review. |
title_short |
Predictors of visceral leishmaniasis relapse in HIV-infected patients: a systematic review. |
title_full |
Predictors of visceral leishmaniasis relapse in HIV-infected patients: a systematic review. |
title_fullStr |
Predictors of visceral leishmaniasis relapse in HIV-infected patients: a systematic review. |
title_full_unstemmed |
Predictors of visceral leishmaniasis relapse in HIV-infected patients: a systematic review. |
title_sort |
predictors of visceral leishmaniasis relapse in hiv-infected patients: a systematic review. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2011 |
url |
https://doi.org/10.1371/journal.pntd.0001153 https://doaj.org/article/becad62a8af44f6894349790ff6d7a2f |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 5, Iss 6, p e1153 (2011) |
op_relation |
http://europepmc.org/articles/PMC3110161?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0001153 https://doaj.org/article/becad62a8af44f6894349790ff6d7a2f |
op_doi |
https://doi.org/10.1371/journal.pntd.0001153 |
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PLoS Neglected Tropical Diseases |
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6 |
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e1153 |
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