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Case Reports
. 2019 Apr 18;19(1):328.
doi: 10.1186/s12879-019-3947-x.

Direct-acting antivirals and visceral leishmaniasis: a case report

Claudia Colomba  1 , Laura Saporito  2 , Paola Di Carlo  2 , Manlio Tolomeo  2 , Adriana Cervo  2 , Alberto Firenze  2 , Marcello Trizzino  2 , Antonio Cascio  2
Affiliations
Case Reports

Direct-acting antivirals and visceral leishmaniasis: a case report

Claudia Colomba et al. BMC Infect Dis. .

Abstract

Background: Visceral leishmaniasis is a vector-borne parasitic disease caused by protozoa belonging to the genus Leishmania. The clinical presentation of visceral leishmaniasis strictly depends on the host immunocompetency, whereas depressive conditions of the immune system impair the capability to resolve the infection and allow reactivation from sites of latency of the parasite.

Case presentation: We describe a case of visceral leishmaniasis (VL) that occurred in a patient with chronic hepatitis C treated with direct-acting antiviral drugs (DAA). The hypothesized mechanism is the alteration of protective inflammation mechanisms secondary to DAA therapy. Downregulation of type II and III IFNs, their receptors, which accompany HCV clearance achieved during treatment with sofosbuvir and ribavirin might have a negative impact on a risk for reactivation of a previous Leishmania infection. We know indeed that IFN-γ is important to enhance killing mechanisms in macrophages, which are the primary target cells of Leishmania.

Conclusion: Since VL is endemic in Sicily as well as in other countries of the Mediterranean basin, physicians should be aware of the possible unmasking of cryptic Leishmania infection by DAAs.

Keywords: Direct-acting antiviral; Hepatitis C; Leishmania; Visceral Leishmaniasis.

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Not applicable.

Consent to publish

Written informed consent was obtained from the patient for publication of this case report. A copy of the written consent is available for review by the Editor of this journal.

Competing interests

The authors declare that they have no competing interests.

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References

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