Visceral leishmaniasis in patients infected with human immunodeficiency virus (HIV)

Article Abstract:

Visceral leishmaniasis, also known as kala-azar, is a disease caused by parasites of the Leishmania species that affects the organs in the abdominal cavity. Visceral leishmaniasis usually occurs among children who live in areas of the world that are endemic for the parasite. The children usually develop an immunity to the parasite. Visceral leishmaniasis has been seen in patients whose immune systems have been compromised, such as patients who have AIDS (acquired immunodeficiency disease syndrome), in areas where the parasite is native. Patients with HIV infections from a hospital in Madrid, Spain were screened for visceral leishmaniasis. Nine cases of visceral leishmaniasis were diagnosed. In seven of the patients, visceral leishmaniasis occurred before AIDS developed, and in two, at the time when or after AIDS developed. Three of the nine patients had had visceral leishmaniasis previously. Leishmaniasis caused the death of five of the nine patients. Therefore, it is felt that HIV-infected individuals who live or travel in areas of the world where Leishmania are endemic should be screened for leishmaniasis. Since leishmaniasis often occurs early in infection with HIV, treatment with agents that can kill the parasite should be given before the onset of AIDS if possible, as this could prevent death from leishmaniasis. It is necessary to screen the patients for leishmaniasis by culturing the parasite, as these patients did not have typical clinical symptoms of the disease, and other possible diagnostic criteria, such as the presence of antibodies to Leishmania or the presence of Leishmania in bone marrow smears, were not detected in all of the patients examined. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Diagnosis, Spain, HIV patients, Opportunistic infections, Kala-azar, Visceral leishmaniasis

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Risk for developing tuberculosis among anergic patients infected with HIV

Article Abstract:

Anergic individuals with HIV infection may have a high risk of developing active tuberculosis (TB). Anergy is reduction in reactivity to the tuberculin skin test in a sensitized individual owing to alterations in the immune system. A study examined the development of active TB among 374 HIV-positive individuals who initially had positive results on the protein purified derivative (PPD) test. Twenty-nine percent of the patients had positive PPD test results, 41% had negative results without skin anergy and 30% were anergic. The risk of developing active tuberculosis was approximately the same for patients with positive PPD test results and those who were anergic who were not receiving preventive treatment for tuberculosis. In areas with a high incidence of TB, anergic individuals with HIV infection should receive preventive treatment with isoniazid.

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Tuberculous meningitis in patients infected with the human immunodeficiency virus

Article Abstract:

HIV-infected individuals who have tuberculosis may have a higher risk of developing meningitis, or inflammation of the brain or spinal cord, than healthy individuals, but their prognosis may be no worse. Out of 2,205 patients with tuberculosis, 455 were infected with HIV, and 1,750 were not. Forty-five HIV-infected patients (10%) had tuberculous meningitis compared to thirty-eight (2%) of HIV-negative patients. Mycobacterium tuberculosis, the bacterium that causes TB, was the bacterium most often associated with meningitis in the HIV-infected patients. HIV-negative and HIV-positive patients with tuberculous meningitis had similar symptoms, complications and cerebrospinal fluid findings. Thirty-three HIV-infected patients and 19 HIV-negative patients were treated with anti-tuberculosis drugs. The mortality rate in the treated patients was 21%.

Tuberculous meningitis, Meningeal tuberculosis

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