Clinical characteristics and treatment outcome of patients with visceral leishmaniasis and HIV co-infection in northwest Ethiopia

被引:78
作者
Hurissa, Zewdu [1 ]
Gebre-Silassie, Samuel [1 ]
Hailu, Workagegnehu [1 ]
Tefera, Tewodros [2 ]
Lalloo, David G. [3 ]
Cuevas, Luis E. [3 ,4 ]
Hailu, Asrat [5 ]
机构
[1] Univ Gondar, Coll Med & Hlth Sci, Gondar, Ethiopia
[2] Kahsay Abera Hosp, Humera, Ethiopia
[3] Univ Liverpool, Liverpool Sch Trop Med, Liverpool L3 5QA, Merseyside, England
[4] UNICEF, UNDP, World Bank, WHO Special Programme Res & Training Trop Dis, Geneva, Switzerland
[5] Univ Addis Ababa, Fac Med, Addis Ababa, Ethiopia
关键词
visceral leishmaniasis; HIV and VL co-infection; treatment outcome; northwest Ethiopia; HUMAN-IMMUNODEFICIENCY-VIRUS; CO-INFECTED PATIENTS; LIPOSOMAL AMPHOTERICIN-B; OPPORTUNISTIC INFECTION; ANTIRETROVIRAL THERAPY; SODIUM STIBOGLUCONATE; HIGH PREVALENCE; AIDS; TUBERCULOSIS; POPULATION;
D O I
10.1111/j.1365-3156.2010.02550.x
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
OBJECTIVES To describe the clinical presentation of patients with visceral leishmaniasis (VL) with and without human immunodeficiency virus (HIV) co-infection and factors associated with poor outcome in northwest Ethiopia. METHOD Retrospective review of 241 patients with VL (92 with and 149 without HIV co-infection). RESULTS HIV co-infection was present in 92 (38%) of the patients. Clinical presentation of VL was indistinguishable between patients with and without HIV co-infection. Co-infected patients had a poorer outcome i.e. either death or treatment failure (31.5% vs. 5.6%, P < 0.001). The presence of tuberculosis or sepsis syndrome among patients with VL and HIV co-infected independently predicted death or treatment failure [odds ratio 4.5 (95% CI 1.47-13.92, P = 0.009) and 9.1 (95% CI 2.16-37.97, P = 0.003), respectively]. Despite having similar clinical presentation at the time of diagnosis, VL and HIV co-infected patients had a higher mortality and treatment failure than immunocompetent patients. CONCLUSION The frequency of HIV co-infection among patients with VL is high in the study area, and this co-infection was associated with death or treatment failure. The clinical management of VL in HIV co-infected patients is a major challenge that requires new treatment approaches to improve its outcome.
引用
收藏
页码:848 / 855
页数:8
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