TABLE 5.

Treatment studies for Leishmania-HIV coinfection

Region, parasiteReferenceDrugfRegimenNo. of patients with initial cure (clinical and/or parasitological)/total no. of patients (%)Severity of side effectsNo. or % of dropoutsNo. of recorded relapses/total no. of patients (%)Study type
Europe, L. infantum 134 SbV20 mg/kg, 28 days29/44 (66)Most serious (cardiotoxicity in six cases [one patient died] and pancreatitis in three cases)1011/24 (46)Randomized comparative trial
AMB28/45 (62)Most serious (severe chills in 1 case, venous thrombosis in 1 case, and nephrotoxicity in 16 cases)158/24 (46)
78 SbV20 mg/kg, 28 days5/25 (33)aMost serious (pancreatitis in five cases, acute renal failure in one case, and leucopenia in one case)103/15 (20)Retrospective study
135 SbV20 mg/kg, 28 days7/19 (37)Most serious (pancreatitis in four cases [all four patients died], renal failure in two cases [both patients died])94/7 (57)Randomized comparative trial
ABLC3 mg/kg, 5 days6/18 (33)Overall mild (seven cases of infusion-related reactions, one case of renal failure)12/4 (50)
ABLC3 mg/kg, 10 days8/20 (42)Overall mild (eight cases of infusion-related reactions)23/8 (38)
189 SbV20 mg/kg, 3-4 weeks61bHyperamylasemia in 15.9% of patients, anemia in 14.7% of patients19%No data per individual drugRetrospective study
AMB0.5-1 mg/kg, 3-4 weeks58bAnemia in 29.4% of patients, renal failure in 17.6% of patients7%No data per individual drug
Ethiopia, L. donovani 31 SbV20 mg/kg, 28 days17/23 (74)No data0Not recordedProspective study
Europe, L. infantum 141 SbV20 mg/kg, 28 days42/51 (82)cHyperamylasemia in eight cases and cardiotoxicity in nine cases (one death)Data not givenNo data per individual drugRetrospective study
AMBAt least 15-mg/kg total dose14/17 (82)dAnemia in six cases and renal failure in five casesData not givenNo data per individual drug
PENT4 mg/kg, 28 days2/3 (67)One case of insulin-dependent diabetesData not givenNo data per individual drug
73 L-AMB100 mg, 21 days11/11 (100)No serious side effects; well tolerated08/11 (73)Open-label dose finding
226 L-AMB4 mg/kg on days 1 to 5, 10, 17, 24, 31, and 389/10 (100)No serious side effects; well tolerated07/7 (100)Open-label dose finding
Ethiopia, L. donovani 215 MILT100 mg, 28 days56/63 (89)Vomiting in 41 cases, 3 of which were serious; diarrhea in 34 cases316 of 52 (31)Randomized comparative trial
SbV20 mg/kg, 40-60 days40/44 (90)Vomiting in 20 cases, 7 of which were serious; diarrhea in 32 cases05/35 (14)
India, L. donovani 243 MILT100 mg, for a mean of 55 dayse25/39 (64)Overall mild (vomiting in 10 cases, diarrhea in 4 cases)Data not given22/25 (88)Case series
  • a One of 25 cases was a relapse.

  • b Fifty-one patients were started on pentavalent antimonials, and 17 were started on AMB, among whom 8 received L-AMB.

  • c Allopurinol (three cases) and IFN-γ (one case) were added to therapy.

  • d In four cases, L-AMB was used.

  • e For two patients, the daily dose was 150 mg.

  • f SbV, pentavalent antimonial; AMB, amphotericin B deoxycholate; L-AMB, liposomal AMB; ABLC, AMB lipid complex; PENT, pentamidine; MILT, miltefosine.