Leishmaniasis in HIV-infected patients: difficulties in diagnostics and treatment

In this article, leishmaniasis is considered in the context of HIV infection, in which this disease appears to be an opportunistic. A general characteristic  of leishmaniasis is given, and the features of the course of infection in immunodeficiency are also presented. In the example of clinical case...

Full description

Saved in:
Bibliographic Details
Main Authors: M. V. Nagibina, A. I. Mazus, N. A. Smirnov, T. P. Bessarab, N. N. Martynova, Yu. Ya. Vengerov, O. A. Tishkevich, D. R. Nabiullina
Format: Article
Language:Russian
Published: Open Systems Publication 2022-01-01
Series:Лечащий Врач
Subjects:
Online Access:https://journal.lvrach.ru/jour/article/view/857
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849404116386709504
author M. V. Nagibina
A. I. Mazus
N. A. Smirnov
T. P. Bessarab
N. N. Martynova
Yu. Ya. Vengerov
O. A. Tishkevich
D. R. Nabiullina
author_facet M. V. Nagibina
A. I. Mazus
N. A. Smirnov
T. P. Bessarab
N. N. Martynova
Yu. Ya. Vengerov
O. A. Tishkevich
D. R. Nabiullina
author_sort M. V. Nagibina
collection DOAJ
description In this article, leishmaniasis is considered in the context of HIV infection, in which this disease appears to be an opportunistic. A general characteristic  of leishmaniasis is given, and the features of the course of infection in immunodeficiency are also presented. In the example of clinical cases, issues featuring diagnostics and treatment  of leishmaniasis are reviewed, the mortality rate of which remains quite high. The accession of Crimea to Russia, the high prevalence of HIV infection in the world, as well as the annually increasing tourist flow to endemic countries, require physicians of all specialties to be aware of this disease. HIV patients deserve special attention, there are already a number of reports that people with HIV are diagnosed with visceral leishmaniasis and are at greater risk of infection than the general population. The manifestations of visceral leishmaniasis among patients with immunodeficiency, as a rule, do not differ from the classical course, however, depending on the degree of suppression of immunity, the disease can take on atypical forms, which complicates timely diagnosis and the appointment of adequate therapy. If the patient has HIV infection, prolonged fever of the wrong type, enlarged lymph nodes, spleen, liver, weight loss > 10%, progressive anemia, neutropenia, thrombocytopenia, hypoalbuminemia and data on stay in regions endemic for leishmaniasis, it is advisable to be tested for visceral leishmaniasis – puncture of bone marrow with staining of smears according to Romanovsky – Giemsa, staging of PCR punctate using a test system for leishmaniasis, and if positive results are obtained, the appointment of pentavalent antimony drugs, second-line  drugs – amphotericin B, liposomal amphotericin B or paromomycin.
format Article
id doaj-art-26aa1c8a262c4e52957efbcfe3428559
institution Kabale University
issn 1560-5175
2687-1181
language Russian
publishDate 2022-01-01
publisher Open Systems Publication
record_format Article
series Лечащий Врач
spelling doaj-art-26aa1c8a262c4e52957efbcfe34285592025-08-20T03:37:06ZrusOpen Systems PublicationЛечащий Врач1560-51752687-11812022-01-01012748010.51793/OS.2021.24.12.011852Leishmaniasis in HIV-infected patients: difficulties in diagnostics and treatmentM. V. Nagibina0A. I. Mazus1N. A. Smirnov2T. P. Bessarab3N. N. Martynova4Yu. Ya. Vengerov5O. A. Tishkevich6D. R. Nabiullina7A.I. Yevdokimov Moscow State Medical and Dental University; Moscow Centre for HIV/AIDS Prevention and Treatment of Moscow Healthcare DepartmentMoscow Centre for HIV/AIDS Prevention and Treatment of Moscow Healthcare DepartmentA.I. Yevdokimov Moscow State Medical and Dental University; Moscow Centre for HIV/AIDS Prevention and Treatment of Moscow Healthcare DepartmentMoscow Centre for HIV/AIDS Prevention and Treatment of Moscow Healthcare DepartmentMoscow Centre for HIV/AIDS Prevention and Treatment of Moscow Healthcare DepartmentA.I. Yevdokimov Moscow State Medical and Dental UniversityMoscow State Infectious Disease Hospital № 2 of Moscow Healthcare DepartmentA.I. Yevdokimov Moscow State Medical and Dental University; Moscow Centre for HIV/AIDS Prevention and Treatment of Moscow Healthcare DepartmentIn this article, leishmaniasis is considered in the context of HIV infection, in which this disease appears to be an opportunistic. A general characteristic  of leishmaniasis is given, and the features of the course of infection in immunodeficiency are also presented. In the example of clinical cases, issues featuring diagnostics and treatment  of leishmaniasis are reviewed, the mortality rate of which remains quite high. The accession of Crimea to Russia, the high prevalence of HIV infection in the world, as well as the annually increasing tourist flow to endemic countries, require physicians of all specialties to be aware of this disease. HIV patients deserve special attention, there are already a number of reports that people with HIV are diagnosed with visceral leishmaniasis and are at greater risk of infection than the general population. The manifestations of visceral leishmaniasis among patients with immunodeficiency, as a rule, do not differ from the classical course, however, depending on the degree of suppression of immunity, the disease can take on atypical forms, which complicates timely diagnosis and the appointment of adequate therapy. If the patient has HIV infection, prolonged fever of the wrong type, enlarged lymph nodes, spleen, liver, weight loss > 10%, progressive anemia, neutropenia, thrombocytopenia, hypoalbuminemia and data on stay in regions endemic for leishmaniasis, it is advisable to be tested for visceral leishmaniasis – puncture of bone marrow with staining of smears according to Romanovsky – Giemsa, staging of PCR punctate using a test system for leishmaniasis, and if positive results are obtained, the appointment of pentavalent antimony drugs, second-line  drugs – amphotericin B, liposomal amphotericin B or paromomycin.https://journal.lvrach.ru/jour/article/view/857hiv infectionleishmaniasisantiretroviral therapyclinical pictureopportunistic disease
spellingShingle M. V. Nagibina
A. I. Mazus
N. A. Smirnov
T. P. Bessarab
N. N. Martynova
Yu. Ya. Vengerov
O. A. Tishkevich
D. R. Nabiullina
Leishmaniasis in HIV-infected patients: difficulties in diagnostics and treatment
Лечащий Врач
hiv infection
leishmaniasis
antiretroviral therapy
clinical picture
opportunistic disease
title Leishmaniasis in HIV-infected patients: difficulties in diagnostics and treatment
title_full Leishmaniasis in HIV-infected patients: difficulties in diagnostics and treatment
title_fullStr Leishmaniasis in HIV-infected patients: difficulties in diagnostics and treatment
title_full_unstemmed Leishmaniasis in HIV-infected patients: difficulties in diagnostics and treatment
title_short Leishmaniasis in HIV-infected patients: difficulties in diagnostics and treatment
title_sort leishmaniasis in hiv infected patients difficulties in diagnostics and treatment
topic hiv infection
leishmaniasis
antiretroviral therapy
clinical picture
opportunistic disease
url https://journal.lvrach.ru/jour/article/view/857
work_keys_str_mv AT mvnagibina leishmaniasisinhivinfectedpatientsdifficultiesindiagnosticsandtreatment
AT aimazus leishmaniasisinhivinfectedpatientsdifficultiesindiagnosticsandtreatment
AT nasmirnov leishmaniasisinhivinfectedpatientsdifficultiesindiagnosticsandtreatment
AT tpbessarab leishmaniasisinhivinfectedpatientsdifficultiesindiagnosticsandtreatment
AT nnmartynova leishmaniasisinhivinfectedpatientsdifficultiesindiagnosticsandtreatment
AT yuyavengerov leishmaniasisinhivinfectedpatientsdifficultiesindiagnosticsandtreatment
AT oatishkevich leishmaniasisinhivinfectedpatientsdifficultiesindiagnosticsandtreatment
AT drnabiullina leishmaniasisinhivinfectedpatientsdifficultiesindiagnosticsandtreatment