Tropical medicine & international health : TM & IH · 2010
Clinical characteristics and treatment outcome of patients with visceral leishmaniasis and HIV co-infection in northwest Ethiopia.
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Hurissa Zewdu, Gebre-Silassie Samuel, Hailu Workagegnehu, Tefera Tewodros, Lalloo David G, Cuevas Luis E, Hailu Asrat
Аннотация
OBJECTIVES: To describe the clinical presentation of patients with visceral leishmaniasis (VL) with and without human immunodeficiency virus (HIV) co-infection and factors associated with poor outcome in northwest Ethiopia.
METHOD: Retrospective review of 241 patients with VL (92 with and 149 without HIV co-infection).
RESULTS: HIV co-infection was present in 92 (38%) of the patients. Clinical presentation of VL was indistinguishable between patients with and without HIV co-infection. Co-infected patients had a poorer outcome i.e. either death or treatment failure (31.5%vs. 5.6%, P < 0.001). The presence of tuberculosis or sepsis syndrome among patients with VL and HIV co-infected independently predicted death or treatment failure [odds ratio 4.5 (95% CI 1.47-13.92, P = 0.009) and 9.1 (95% CI 2.16-37.97, P = 0.003), respectively]. Despite having similar clinical presentation at the time of diagnosis, VL and HIV co-infected patients had a higher mortality and treatment failure than immunocompetent patients.
CONCLUSION: The frequency of HIV co-infection among patients with VL is high in the study area, and this co-infection was associated with death or treatment failure. The clinical management of VL in HIV co-infected patients is a major challenge that requires new treatment approaches to improve its outcome.
METHOD: Retrospective review of 241 patients with VL (92 with and 149 without HIV co-infection).
RESULTS: HIV co-infection was present in 92 (38%) of the patients. Clinical presentation of VL was indistinguishable between patients with and without HIV co-infection. Co-infected patients had a poorer outcome i.e. either death or treatment failure (31.5%vs. 5.6%, P < 0.001). The presence of tuberculosis or sepsis syndrome among patients with VL and HIV co-infected independently predicted death or treatment failure [odds ratio 4.5 (95% CI 1.47-13.92, P = 0.009) and 9.1 (95% CI 2.16-37.97, P = 0.003), respectively]. Despite having similar clinical presentation at the time of diagnosis, VL and HIV co-infected patients had a higher mortality and treatment failure than immunocompetent patients.
CONCLUSION: The frequency of HIV co-infection among patients with VL is high in the study area, and this co-infection was associated with death or treatment failure. The clinical management of VL in HIV co-infected patients is a major challenge that requires new treatment approaches to improve its outcome.