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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
Is visceral leishmaniasis different in immunocompromised patients without human immunodeficiency virus? A comparative, multicenter retrospective cohort analysis
American Journal of Tropical Medicine and Hygiene, Volume 97, No. 4, Year 2017
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Description
Although visceral leishmaniasis (VL) can affect immunocompromised patients, data from the human immunodeficiency virus (HIV) infection context are limited, and the characteristics of VL in other immunosuppression scenarios are not well defined. A retrospective review of all cases of VL in immunocompromised patients from January 1997 to December 2014 in two Spanish hospitals on the Mediterranean coast was performed. We included 18 transplant recipients (kidney: 7, liver: 4, lung: 3, heart: 2, and blood marrow: 2), 12 patients with other causes of immunosuppression (myasthenia gravis: 3 and rheumatoid arthritis: 2), and 73 VL HIV-positive patients. Fever was more common in transplant patients (94.4%) and patients with other types of immunosuppression (100%) than in HIV-positive individuals (73.3%). Hepatomegaly was less common in transplant recipients (27.8%) and patients with other types of immunosuppression (41.7%) compared with HIV-positive patients (69.9%) (P = 0.01; P = 0.001, respectively). Patients with other types of immunosuppression had amedian leukocyte count of 1.5 × 109/L, significantly lower thanHIV-positive patients (2.5 × 109/L) (P = 0.04). Serology was more commonly positive in nontransplant immunosuppressed individuals (75%) and transplant recipients (78.6%) than inHIV-patients (13.8%)(P<0.001).Antimonial therapywas rarelyusedin transplant recipients (1.9%) andnever inpatientswith other immunosuppressive conditions,whereas 34.2%ofHIV-positive patients received it (P= 0.05 and P = 0.01, respectively). Mortality was 16.7%in both transplant recipients and patients with other immunosuppressive conditions and15.1%in HIV-positivepatients. The features ofVLmaybedifferent in immunosuppressedpatients,withmore fever and less hepatomegaly and leukopenia than in HIV-infected patients. © Copyright 2017 by The American Society of Tropical Medicine and Hygiene.
Authors & Co-Authors
Ramos-Rincón, José Manuel
Spain, Alicante
Hospital General Universitario de Alicante
Spain, Elche
Universidad Miguel Hernández de Elche
Merino-De-Lucas, Esperanza
Spain, Elche
Universidad Miguel Hernández de Elche
Spain, Alicante
Hospital General Universitario de Alicante
Blanes, Marino
Spain, Valencia
Hospital Clinico Universitario de Valencia
Portilla-Sogorb, Joaquin Sogorb
Spain, Alicante
Hospital General Universitario de Alicante
Spain, Elche
Universidad Miguel Hernández de Elche
Statistics
Citations: 13
Authors: 4
Affiliations: 3
Identifiers
Doi:
10.4269/ajtmh.16-0940
ISSN:
00029637
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Cohort Study