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Visceral leishmaniasis in HIV-infected patients: epidemiological and bio-clinical features.
Lamaury I; Reynes J; Pratlong F; Dereure J; Dedet JP; Janbon F; Service
November 30, 1993
Int Conf AIDS. 1993 Jun 6-11;9(1):378 (abstract no. PO-B10-1457). Unique

OBJECTIVE: To describe the epidemiological-bioclinical features and outcome of visceral leishmaniasis (VL) in HIV-infected adults. METHODS: From November 1989 to August 1992, seven cases of VL in HIV patients (1 female and 6 male: 5 IV drugs addicts, 1 blood transfusion and 1 homosexual) were diagnosed at the Infectious Diseases department of Montpellier Hospital (France) by isolation of Leishmania infantum in bone marrow culture. All the Leishmania isolates were identified by their isoenzymes profiles using 15 enzymatic systems. RESULTS: All patients were symptomatic (3 IVC2, 4 IV C1) before VL diagnosis. Fever (7/7), splenomegaly (5/7), hypergammaglobulinemia (4/7) and pancytopenia 4/7) were the most relevant clinical features. In 4 cases, leishmanial antibodies were negative. Five patients were treated with Meglumine Antimoniate and 2 with Amphotericin B-Intralipid*. One died during the first course. Two out of 6 had relapses. Three died for other reasons. The zymodeme MON-1 was the most frequently encountered (4/7). However, zymodemes qualified as dermotropic (MON-29 and MON-33) were identified in two cases. Furthermore, a previously underscribed L. infantum zymodeme, MON-183, was isolated from one patient. CONCLUSION: AIDS is increasing the number of VL cases with description of new causative zymodemes, stressing the necessity of systematic characterization of the Leishmania strains isolated.

*AIDS-Related Opportunistic Infections/EPIDEMIOLOGY *Leishmaniasis, Visceral/EPIDEMIOLOGY