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PLoS Negl Trop Dis. 2018 May 10;12(5):e0006375. doi: 10.1371/journal.pntd.0006375. eCollection 2018 May.

New insights into leishmaniasis in the immunosuppressed.

Author information

1
Swedish International Development Agency (Sida), and Microbiology, Tumor and Cell biology (MTC), Karolinska Institutet, Solna, Sweden.
2
Federal University of Piauí, Teresina-PI, Brazil.
3
Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
4
Médecins Sans Frontières, New Delhi, India.
5
World Health Centre (WHO) Collaborating Centre for Leishmaniasis, National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain.
6
Leishmaniasis, IDM Unit, Neglected Tropical Diseases, WHO, Geneva, Switzerland.

Abstract

Immunosuppression contributes significantly to the caseload of visceral leishmaniasis (VL). HIV coinfection, solid organ transplantation, malnutrition, and helminth infections are the most important immunosuppression-related factors. This review briefly describes the challenges of these associations. East Africa and the Indian subcontinent are the places where HIV imposes the highest burden in VL. In the highlands of Northern Ethiopia, migrant rural workers are at a greater risk of coinfection and malnutrition, while in India, HIV reduces the sustainability of a successful elimination programme. As shown from a longitudinal cohort in Madrid, VL is an additional threat to solid organ transplantation. The association with malnutrition is more complex since it can be both a cause and a consequence of VL. Different regimes for therapy and secondary prevention are discussed as well as the role of nutrients on the prophylaxis of VL in poverty-stricken endemic areas.

PMID:
29746470
PMCID:
PMC5944929
DOI:
10.1371/journal.pntd.0006375
[Indexed for MEDLINE]
Free PMC Article

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