Double - Trouble- Relapsing Leishmaniasis in a Virologically Suppressed HIV Positive Patient

Area of Science:

• Infectious Diseases
• Immunology
• HIV Medicine

Background:

• Visceral leishmaniasis is an opportunistic infection in patients with advanced HIV.
• Recurrent infections pose a significant challenge in managing co-infected individuals.
• Second-line antiretroviral therapy (ART) is crucial for immune reconstitution.

Observation:

• A middle-aged male patient with a history of retroviral disease on second-line Anti-Retroviral Therapy (ART) presented with recurrent episodes of visceral leishmaniasis.
• Diagnosis was confirmed through bone marrow examination, indicating the parasite's presence in the hematopoietic system.

Findings:

• The patient received a combination therapy comprising liposomal amphotericin B and miltefosine.
• This treatment regimen was employed to manage the three distinct episodes of visceral leishmaniasis observed during the course of the patient's illness.

Implications:

• Combination therapy with liposomal amphotericin B and miltefosine can be an effective strategy for treating recurrent visceral leishmaniasis in patients with advanced HIV.
• This case underscores the importance of vigilant monitoring and prompt treatment of opportunistic infections in individuals undergoing long-term ART.
• Further research into optimal treatment protocols for visceral leishmaniasis in the context of complex comorbidities like HIV is warranted.