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Review
. 2016 Oct 7:8:147-156.
doi: 10.2147/HIV.S93789. eCollection 2016.

Leishmaniasis-HIV coinfection: current challenges

José Angelo Lauletta Lindoso  1 , Mirella Alves Cunha  2 , Igor Thiago Queiroz  3 , Carlos Henrique Valente Moreira  4
Affiliations
Review

Leishmaniasis-HIV coinfection: current challenges

José Angelo Lauletta Lindoso et al. HIV AIDS (Auckl). .

Abstract

Leishmaniasis - human immunodeficiency virus (HIV) coinfection can manifest itself as tegumentary or visceral leishmaniasis. Almost 35 countries have reported autochthonous coinfections. Visceral leishmaniasis is more frequently described. However, usual and unusual manifestations of tegumentary leishmaniasis have been reported mainly in the Americas, but the real prevalence of Leishmania infection in HIV-infected patients is not clear. Regarding the clinical manifestations, there are some reports showing unusual manifestations in visceral leishmaniasis and tegumentary leishmaniasis in HIV-infected patients; yet, the usual manifestations are more frequent. Leishmaniasis diagnosis relies on clinical methods, but serological tests are used to diagnose visceral leishmaniasis despite them having a low sensitivity to tegumentary leishmaniasis. The search for the parasite is used to diagnose both visceral leishmaniasis and tegumentary leishmaniasis. Nevertheless, in HIV-infected patients, the sensitivity of serology is very low. Drugs available to treat leishmaniasis are more restricted and cause severe side effects. Furthermore, in HIV-infected patients, these side effects are more prominent and relapses and lethality are more recurrent. In this article, we discuss the current challenges of tegumentary leishmaniasis and visceral leishmaniasis-HIV infection, focusing mainly on the clinical manifestations, diagnosis, and treatment of leishmaniasis.

Keywords: HIV infection; clinical manifestations; coinfection; diagnosis; epidemiology; leishmaniasis; treatment.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Life cycle of Leishmania into the vertebrate and invertebrate host. Note: Image modified from Centers for Disease Control and Prevention. Available from http://phil.cdc.gov/phil/home.asp.
Figure 2
Figure 2
Lesions of tegumentary leishmaniasis. Note: (A) Typical cutaneous lesion- localized cutaneous leishmaniasis, (B) Unusual manifestation of cutaneous leishmaniasis, characterized by large cutaneous ulceration, (C) and (D) Mucocutaneous leishmaniasis.
Figure 3
Figure 3
Clinical manifestation of visceral leishmaniasis in HIV-infected patient, showing hepatomegaly and splenomegaly.
See this image and copyright information in PMC

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