'Active chronic visceral leishmaniasis' in HIV-1-infected patients demonstrated by biological and clinical long-term follow-up of 10 patients.

OBJECTIVES

The aim of the study was to describe a new evolutionary form of visceral leishmaniasis observed in immunocompromised patients.

METHODS

We carried out long-term clinical and biological follow-up of 10 HIV-1/Leishmania-coinfected patients presenting numerous secondary visceral leishmaniasis episodes despite treatment, with the follow-up time ranging from 0.5 to 10 years.

RESULTS

Analysis of polymerase chain reaction (PCR) and blood culture results demonstrated continuous multiplication and circulation of parasites despite treatment, both during asymptomatic periods and during secondary visceral leishmaniasis episodes. This condition may be termed 'chronic' because of the presence of relapses over a period of several years and 'active' because of the continuous blood circulation of the parasite.

CONCLUSION

We wish to define 'active chronic visceral leishmaniasis' as a novel nosological entity observed in HIV-1/Leishmania-coinfected patients.