Liposomal amphotericin B and leishmaniasis: dose and response
Shyam Sundar1, Jaya Chakravarty
1Department of Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi - 221 005, India.
Journal of Global Infectious Diseases
|July 8, 2010
Summary
Liposomal amphotericin B effectively treats visceral leishmaniasis (VL), especially in HIV co-infected patients. Further trials are needed to optimize treatment and explore combination therapies for this group.
Area of Science:
- Infectious Diseases
- Pharmacology
- Tropical Medicine
Background:
- Visceral leishmaniasis (VL) treatment is evolving.
- Liposomal amphotericin B (LAB) is increasingly utilized for VL.
- LAB is a preferred treatment for immunocompetent patients in endemic regions and for HIV-VL co-infection.
Purpose of the Study:
- To evaluate the efficacy of liposomal amphotericin B in treating visceral leishmaniasis.
- To highlight the role of LAB in immunocompetent and HIV-VL co-infected patients.
- To identify the need for further research in optimizing treatment for HIV-VL co-infection.
Main Methods:
- Review of current treatment protocols and clinical trial data for liposomal amphotericin B in visceral leishmaniasis.
- Analysis of parasite susceptibility variations and dosage effectiveness.
- Assessment of treatment outcomes in different patient populations.
Main Results:
- A total dose of 20 mg/kg of liposomal amphotericin B is effective in immunocompetent patients, despite regional parasite susceptibility variations.
- Liposomal amphotericin B is the treatment of choice for immunocompetent patients in the Mediterranean region.
- Liposomal amphotericin B is the preferred drug for managing HIV/VL co-infection.
Conclusions:
- Liposomal amphotericin B is a key therapeutic agent for visceral leishmaniasis.
- Randomized clinical trials are essential to optimize liposomal amphotericin B treatment and secondary prophylaxis in HIV-VL co-infected patients.
- Short-course combination therapy with liposomal amphotericin B may be a viable alternative, especially with preferential pricing in endemic areas.
More Related Videos
12:02An Efficient Method for the Synthesis of Peptoids with Mixed Lysine-type/Arginine-type Monomers and Evaluation of Their Anti-leishmanial Activity
Published on: November 2, 2016
10:01Quantification of Intracellular Growth Inside Macrophages is a Fast and Reliable Method for Assessing the Virulence of Leishmania Parasites
Published on: March 16, 2018
Related Concept Videos
01:21Antiprotozoal Agents
Leishmaniasis is a widespread parasitic disease caused by several Leishmania species. It affects millions of people each year and remains a major public health problem in endemic regions. First-line treatment relies on pentavalent antimonials, including meglumine antimoniate and sodium stibogluconate. Even so, how these drugs work has not been fully clear, especially their interaction with parasite-specific biochemical pathways. One key target is trypanothione reductase (TR), an enzyme that...
01:30Leishmaniasis
Leishmaniasis is a protozoal disease caused by species of the genus Leishmania and transmitted through the bite of infected female sandflies. The parasite exists in two principal morphological forms during its life cycle. A sandfly acquires intracellular amastigotes from an infected reservoir host, such as a dog. Within the sandfly, these forms differentiate into motile, flagellated promastigotes. During a subsequent blood meal, promastigotes are injected into the human host, where they...
01:15Antifungal Agents
Amphotericin B is a broad-spectrum antifungal agent that exploits structural differences between fungal and mammalian cell membranes. Its amphipathic structure—featuring a hydrophobic polyene-lactone ring and a hydrophilic region containing mycosamine and carboxylic acid groups—enables selective binding to ergosterol, a sterol predominantly found in fungal plasma membranes. This selective interaction underlies the drug’s antifungal activity, although weak binding to cholesterol contributes to...
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion
In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
01:27Cryptococcal Meningitis
Cryptococcal meningitis is a life-threatening opportunistic infection predominantly associated with HIV/AIDS, accounting for over 100,000 deaths annually worldwide. However, it also affects individuals with other forms of immunosuppression, including those undergoing immunosuppressive therapy, organ transplant recipients, patients with innate immunodeficiencies, and individuals with hematological disorders. The infection is caused mainly by Cryptococcus neoformans and Cryptococcus gattii,...