Prophylaxis of visceral leishmaniasis in human immunodeficiency virus-infected patients

Esteve Ribera; Imma Ocaña; Jordi De Otero; Emilia Cortes; Isabel Gasser; Albert Pahissa

doi:10.1016/S0002-9343(97)89503-4

Prophylaxis of visceral leishmaniasis in human immunodeficiency virus-infected patients

Esteve Ribera, Imma Ocaña, Jordi De Otero, Emilia Cortes, Isabel Gasser, Albert Pahissa

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Resum

Per avaluar l'eficàcia de dos règims amb allopurinol o antimoni pentavalent com a profilaxi secundària per a la leishmaniosi visceral (LV) en pacients infectats pel virus d'immunodeficiència humana (VIH). DISSENY: Estudi retrospectiu, no aleatoritzat i obert. ENTORN: Un hospital universitari terciari de 1000 llits a Barcelona. PACIENTS: Quaranta-sis individus majors de 14 anys infectats pel VIH que s'havien recuperat d'un episodi de LV entre gener del 1988 i febrer del 1995. INTERVENCIÓ: Vint pacients no van rebre cap profilaxi, nou van prendre 300 mg/8 h d'allopurinol i disset van prendre 850 mg un cop al mes d'antimoni pentavalent. Es va fer seguiment dels pacients cada tres mesos i el punt final de l'estudi era la recaiguda de LV. RESULTATS: Vint-i-un individus van tenir una LV recurrent: 13 de 20 en el grup control (65%), cinc de nou en el grup d'allopurinol (56%) i tres de disset en el grup antimonial (18%). Les estimacions de Kaplan-Meier de la probabilitat de romandre sense recaiguda als dotze mesos van ser del 9% sense profilaxi (IC 95%, 0-22%), 21% amb allopurinol (IC 95%, 0-51%) i 93% amb antimonials (IC 95%, 82-100%) (P < 0.001). L'anàlisi multivariada va mostrar que les úniques variables significatives relacionades amb el curs recurrent de la LV van ser l'assignació al grup antimonial i el fet que el pacient hagués patit un episodi previ de LV. CONCLUSIONS: L'antimoni pentavalent administrat un cop al mes és eficaç en la prevenció de les recaigudes de la LV en individus infectats pel VIH. És un tractament de baix cost que ha demostrat ser ben tolerat. Per tant, l'antimoni pentavalent s'hauria de considerar com a agent adequat per a la profilaxi secundària contra la LV.

Idioma original	Anglès
Pàgines (de-a)	496-501
Revista	American Journal of Medicine
Volum	100
Número	5
DOIs	https://doi.org/10.1016/S0002-9343(97)89503-4
Estat de la publicació	Publicada - 1 de gen. 1996

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10.1016/S0002-9343(97)89503-4

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@article{867369e306bb4137b5e16c15b1345a7d,

title = "Prophylaxis of visceral leishmaniasis in human immunodeficiency virus-infected patients",

abstract = "To assess the effectiveness of two regimens with allopurinol or pentavalent antimony as secondary prophylaxis for visceral leishmaniasis (VL) in human immunodeficiency virus (HIV)-infected patients. DESIGN: Retrospective, nonrandomized, open trial. SETTING: A 1,000-bed academic tertiary institutional hospital in Barcelona. PATIENTS: Forty-six individuals over 14 years old with HIV infection, who recovered from an episode of VL between January 1988 and February 1995. INTERVENTIONS: Twenty patients did not receive any prophylaxis, nine received 300 mg/8 h of allopurinol, and 17 received 850 mg once-a-month of pentavalent antimony. Patients were followed-up every 3 months, and the endpoint of study was relapse of VL. RESULTS: Twenty-one patients had recurrent VL: 13 of 20 in the control group (65\%), 5 of 9 in the allopurinol group (56\%), and 3 of 17 in the antimonial group (18\%). Kaplan-Meier estimates of the probability of remaining relapse-free at 12 months were 9\% without prophylaxis (95\% Cl, 0-22\%), 21\% with allopurinol (95\% Cl, 0-51\%), and 93\% with antimonials (95\% Cl, 82-100\%) (P < 0.001). Multivariate analysis showed that the only significant variables related to relapsing course of VL were assignment to the antimonial group, and the fact that the patient had experienced a previous episode of VL. CONCLUSIONS. Pentavalent antimony given once a month is effective in the prevention of VL relapses in HIV-infected individuals. It is a low-cost treatment that proved to be well tolerated. Therefore, pentavalent antimony should be considered a suitable agent for secondary prophylaxis against VL.",

author = "Esteve Ribera and Imma Oca{\~n}a and \{De Otero\}, Jordi and Emilia Cortes and Isabel Gasser and Albert Pahissa",

year = "1996",

month = jan,

day = "1",

doi = "10.1016/S0002-9343(97)89503-4",

language = "English",

volume = "100",

pages = "496--501",

journal = "American Journal of Medicine",

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TY - JOUR

T1 - Prophylaxis of visceral leishmaniasis in human immunodeficiency virus-infected patients

AU - Ribera, Esteve

AU - Ocaña, Imma

AU - De Otero, Jordi

AU - Cortes, Emilia

AU - Gasser, Isabel

AU - Pahissa, Albert

PY - 1996/1/1

Y1 - 1996/1/1

N2 - To assess the effectiveness of two regimens with allopurinol or pentavalent antimony as secondary prophylaxis for visceral leishmaniasis (VL) in human immunodeficiency virus (HIV)-infected patients. DESIGN: Retrospective, nonrandomized, open trial. SETTING: A 1,000-bed academic tertiary institutional hospital in Barcelona. PATIENTS: Forty-six individuals over 14 years old with HIV infection, who recovered from an episode of VL between January 1988 and February 1995. INTERVENTIONS: Twenty patients did not receive any prophylaxis, nine received 300 mg/8 h of allopurinol, and 17 received 850 mg once-a-month of pentavalent antimony. Patients were followed-up every 3 months, and the endpoint of study was relapse of VL. RESULTS: Twenty-one patients had recurrent VL: 13 of 20 in the control group (65%), 5 of 9 in the allopurinol group (56%), and 3 of 17 in the antimonial group (18%). Kaplan-Meier estimates of the probability of remaining relapse-free at 12 months were 9% without prophylaxis (95% Cl, 0-22%), 21% with allopurinol (95% Cl, 0-51%), and 93% with antimonials (95% Cl, 82-100%) (P < 0.001). Multivariate analysis showed that the only significant variables related to relapsing course of VL were assignment to the antimonial group, and the fact that the patient had experienced a previous episode of VL. CONCLUSIONS. Pentavalent antimony given once a month is effective in the prevention of VL relapses in HIV-infected individuals. It is a low-cost treatment that proved to be well tolerated. Therefore, pentavalent antimony should be considered a suitable agent for secondary prophylaxis against VL.

AB - To assess the effectiveness of two regimens with allopurinol or pentavalent antimony as secondary prophylaxis for visceral leishmaniasis (VL) in human immunodeficiency virus (HIV)-infected patients. DESIGN: Retrospective, nonrandomized, open trial. SETTING: A 1,000-bed academic tertiary institutional hospital in Barcelona. PATIENTS: Forty-six individuals over 14 years old with HIV infection, who recovered from an episode of VL between January 1988 and February 1995. INTERVENTIONS: Twenty patients did not receive any prophylaxis, nine received 300 mg/8 h of allopurinol, and 17 received 850 mg once-a-month of pentavalent antimony. Patients were followed-up every 3 months, and the endpoint of study was relapse of VL. RESULTS: Twenty-one patients had recurrent VL: 13 of 20 in the control group (65%), 5 of 9 in the allopurinol group (56%), and 3 of 17 in the antimonial group (18%). Kaplan-Meier estimates of the probability of remaining relapse-free at 12 months were 9% without prophylaxis (95% Cl, 0-22%), 21% with allopurinol (95% Cl, 0-51%), and 93% with antimonials (95% Cl, 82-100%) (P < 0.001). Multivariate analysis showed that the only significant variables related to relapsing course of VL were assignment to the antimonial group, and the fact that the patient had experienced a previous episode of VL. CONCLUSIONS. Pentavalent antimony given once a month is effective in the prevention of VL relapses in HIV-infected individuals. It is a low-cost treatment that proved to be well tolerated. Therefore, pentavalent antimony should be considered a suitable agent for secondary prophylaxis against VL.

UR - https://www.scopus.com/pages/publications/0030001468

U2 - 10.1016/S0002-9343(97)89503-4

DO - 10.1016/S0002-9343(97)89503-4

M3 - Article

SN - 0002-9343

VL - 100

SP - 496

EP - 501

JO - American Journal of Medicine

JF - American Journal of Medicine

IS - 5

ER -

Prophylaxis of visceral leishmaniasis in human immunodeficiency virus-infected patients

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