[Leishmaniasis and human immunodeficiency virus infections]

Area of Science:

• Infectious Diseases
• Immunology
• Parasitology

Context:

• Visceral leishmaniasis (VL) and human immunodeficiency virus (HIV) co-infection is a significant global health concern.
• Southern Europe, particularly Spain, France, and Italy, represents a key geographical area for this co-infection.
• Co-infection rates range from 2-7% in acquired immunodeficiency syndrome (AIDS) patients, underscoring its clinical relevance.

Purpose:

• To comprehensively review the epidemiological, clinical, and biological characteristics of visceral leishmaniasis/human immunodeficiency virus co-infection.
• To analyze published case literature to understand the presentation and outcomes of this dual infection.
• To identify prevalent parasite strains and associated opportunistic diseases in co-infected patients.

Summary:

• A literature review of 239 cases reveals that visceral leishmaniasis/human immunodeficiency virus co-infection predominantly occurs in Southern Europe.
• Beyond classical symptoms, approximately 10% of cases present with atypical manifestations, including cutaneous, digestive, or pulmonary involvement.
• The parasite Leishmania infantum was isolated, with nine zymodemes identified, including two novel ones, and frequent co-occurrence with other opportunistic infections was noted.

Impact:

• This review provides critical insights into the multifaceted nature of visceral leishmaniasis and HIV co-infection.
• Understanding atypical presentations and associated risks is crucial for timely diagnosis and effective management of co-infected patients.
• The identification of new zymodemes may inform future research on parasite-host interactions and therapeutic strategies.