Successful use of miltefosine and sodium stibogluconate, in combination, for the treatment of an HIV-positive patient with visceral leishmaniasis: a case report and brief review of the literature.

摘要

Visceral leishmaniasis (VL) is particularly difficult to treat in patients who are co-infected with HIV. Whilst liposomal amphotericin (L-AmpB), paromomycin and miltefosine have all been shown to be very successful replacements for the traditional antimony therapy, especially in areas with resistance, their use in those with HIV co-infection has brought disappointingly little additional benefit, even for those on highly active antiretroviral therapy (Laguna, 2003; Ritmeijer et at, 2006). Calls have been made to consider the use of combination antileishmanial therapy - particularly in HIV co-infection - to shorten treatment duration and protect against drug resistance (Berman et al, 2006; Jha, 2006). Here, the successful cure of relapsing VL in a man with HIV co-infection, using a combination of two antileishmanial agents, is reported.