Combination therapy treats leishmaniasis, HIV patients

Co-infection with visceral leishmaniasis (VL) and human immunodeficiency virus (HIV) has been observed in at least 35 countries on four continents and requires special case management. Currently, the World Health Organisation recommends AmBisome monotherapy for treatment. Now, researchers reporting in PLOS Neglected Tropical Diseases (NTD) have showed that a combination therapy of AmBisome and miltefosine is more effective.

HIV affects VL by increasing its incidence, altering its symptoms and severity, and worsening treatment outcomes and relapse rates. While affective antiretroviral therapies have lowered the incidence of VL in HIV, it still remains a prevalent co-infection in some places. In Northwest Ethiopia, HIV rates among VL patients range from 20 to 40%. Studies have shown that 30 mg/kg AmBisome is effective in 43-70% of HIV co-infected patients, and also carries toxicity and an increased risk of death. "The results of this randomised trial strongly support a change in the treatment recommendations for HIV-VL co-infected patients," the researchers say.