Leishmaniasis-HIV coinfection: current challenges

Area of Science:

• Infectious Diseases
• Immunology
• Tropical Medicine

Background:

• Leishmaniasis-HIV coinfection is reported in nearly 35 countries, with visceral leishmaniasis being more common.
• While usual manifestations are frequent, unusual tegumentary and visceral leishmaniasis presentations occur in HIV-coinfected individuals.
• The true prevalence of Leishmania infection in HIV patients remains unclear.

Approach:

• Review of clinical manifestations, diagnostic challenges, and treatment limitations for leishmaniasis in HIV-coinfected patients.
• Analysis of diagnostic methods including clinical evaluation, serology, and parasite detection.
• Discussion of therapeutic drug limitations and increased side effects in the context of HIV coinfection.

Key Points:

• Diagnostic accuracy is compromised in HIV-coinfected patients, particularly with low serology sensitivity for tegumentary leishmaniasis.
• Parasite detection is crucial but challenging.
• Treatment options are limited, with higher rates of severe side effects, relapses, and mortality in coinfected individuals.

Conclusions:

• Current diagnostic and treatment strategies for leishmaniasis are inadequate for HIV-coinfected patients.
• Further research is needed to improve diagnostic sensitivity and develop safer, more effective treatments.
• Addressing the complexities of leishmaniasis-HIV coinfection is critical for patient outcomes.