Leishmania and HIV co-infection: first naturally Leishmania strain presenting decreased susceptibility to miltefosine, recovered from a patient in Portugal

• DOI: 10.1016/j.jiph.2024.03.008
• Publication Date: 2024-03-13T08:18:43Z
• Authors: Ana Isabel Pinto; Cátia Caldas; Nuno Santarém; Sara Luelmo; Inês Costa; Carlos Martins; Ricardo Monteiro; Sílvia Conde; Raquel Tavares; Anabela Cordeiro ...
• Keywords: Miltefosine; Viremia

In Europe, up to 70% of visceral leishmaniasis (VL) cases occurring in adults living with HIV. People HIV VL co-infection often display persistent parasitemia, requiring chronic intermittent anti-Leishmania therapies. Consequently, frequent relapses and higher mortality rates are common these individuals. As such, it is paramount importance understand the reasons for parasite persistence improve infection management. To outline possible causes treatment failure context HIV-VL, we followed a person HIV-VL nine years 12-month period. We characterized: HIV-related clinicopathological alterations (CD4+ T counts viremia) Leishmania-specific seroreactivity, quantification pro-inflammatory cytokines upon stimulation studied Leishmania clinical isolate recovered during this The subject presented controlled viremia low CD4+ counts. remained PCR positive also seropositive. cellular response antigens was erratic. identified as first infantum case evidence decreased miltefosine susceptibility Portugal. Treatment multifactorial process driven by host determinants. Still, real-time determination drug profiles isolates an unexplored resource monitoring VL.