ArticlePLoS neglected tropical diseases2015
Use of Pentamidine As Secondary Prophylaxis to Prevent Visceral Leishmaniasis Relapse in HIV Infected Patients, the First Twelve Months of a Prospective Cohort Study.
Article in PLoS neglected tropical diseases, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers.
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Who cites it
32 citing papers in PubMed.
- A randomized trial of AmBisome monotherapy and AmBisome and miltefosine combination to treat visceral leishmaniasis in HIV co-infected patients in Ethiopia.PLoS neglected tropical diseases · 2019Trial
- Antigen Detection in Urine for Noninvasive Diagnosis and Treatment Monitoring of Visceral Leishmaniasis in Human Immunodeficiency Virus Coinfected Patients: An Exploratory Analysis from Ethiopia.The American journal of tropical medicine and hygiene · 2018Trial
- Long-term Clinical Outcomes in Visceral Leishmaniasis/Human Immunodeficiency Virus-Coinfected Patients During and After Pentamidine Secondary Prophylaxis in Ethiopia: A Single-Arm Clinical Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2018Trial
- Trial
- Validation and Clinical Evaluation of a Novel Method To Measure Miltefosine in Leishmaniasis Patients Using Dried Blood Spot Sample Collection.Antimicrobial agents and chemotherapy · 2016Trial
- Peptide-Enabled Nanoplatforms for Malaria and Leishmaniasis: From Intracellular Targeting to Translational Diagnostic Perspectives.ChemMedChem · 2026Review
- A Diagnostic Algorithm Based on Urine Antigen and Blood Polymerase Chain Reaction Testing for Visceral Leishmaniasis in HIV-Coinfected Patients in Northwest Ethiopia.The American journal of tropical medicine and hygiene · 2026Article
- Unravelling drug resistance in leishmaniasis: genomic adaptations and emerging therapies.Frontiers in molecular biosciences · 2025Review
- Insights to the HIV-associated visceral leishmaniasis clinical outcome: lessons learned about immune mediated disorders.Frontiers in immunology · 2025Review
- Factors associated with relapse and hospital death in patients coinfected with visceral leishmaniasis and HIV: a longitudinal study.BMC infectious diseases · 2023Article
- Immunotherapy and immunochemotherapy in combating visceral leishmaniasis.Frontiers in medicine · 2023Review
- How I Approach Leishmaniasis: Diagnosis and Treatment in the United States.Journal of the Pediatric Infectious Diseases Society · 2022Article
- Synthesis, antimalarial, antileishmanial evaluation, and molecular docking study of some 3-aryl-2-styryl substituted-4(3H)-quinazolinone derivatives.BMC chemistry · 2022Article
- Limitations of current chemotherapy and future of nanoformulation-based AmB delivery for visceral leishmaniasis-An updated review.Frontiers in bioengineering and biotechnology · 2022Review
- Case Report: Intravenous Pentamidine Rescue Treatment for Active Chronic Visceral Leishmaniasis in an HIV-1 Infected Patient.The American journal of tropical medicine and hygiene · 2021Article
- Pentamidine Inhibits Ovarian Cancer Cell Proliferation and Migration by Maintaining Stability of PTEN in vitro.Drug design, development and therapy · 2021Article
- Pentamidine inhibits prostate cancer progression via selectively inducing mitochondrial DNA depletion and dysfunction.Cell proliferation · 2020Article
- Multiple Relapses of Visceral Leishmaniasis in HIV Co-Infected Patients: A Case Series from Ethiopia.Current therapeutic research, clinical and experimental · 2020Article
- Long term outcomes and prognostics of visceral leishmaniasis in HIV infected patients with use of pentamidine as secondary prophylaxis based on CD4 level: a prospective cohort study in Ethiopia.PLoS neglected tropical diseases · 2019Article
- The initial effectiveness of liposomal amphotericin B (AmBisome) and miltefosine combination for treatment of visceral leishmaniasis in HIV co-infected patients in Ethiopia: A retrospective cohort study.PLoS neglected tropical diseases · 2018Article
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16 authors.
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Abstract
backgroundVisceral leishmaniasis (VL) has become an important opportunistic infection in persons with HIV-infection in VL-endemic areas. The co-infection leads to profound immunosuppression and high rate of annual VL recurrence. This study assessed the effectiveness, safety and feasibility of monthly pentamidine infusions to prevent recurrence of VL in HIV co-infected patients.
methodsA single-arm, open-label trial was conducted at two leishmaniasis treatment centers in northwest Ethiopia. HIV-infected patients with a VL episode were included after parasitological cure. Monthly infusions of 4 mg/kg pentamidine-isethionate diluted in normal-saline were started for 12 months. All received antiretroviral therapy (ART). Time-to-relapse or death was the primary end point.
resultsSeventy-four patients were included. The probability of relapse-free survival at 6 months and at 12 months was 79% and 71% respectively. Renal failure, a possible drug-related serious adverse event, occurred in two patients with severe pneumonia. Forty-one patients completed the regimen taking at least 11 of the 12 doses. Main reasons to discontinue were: 15 relapsed, five died and seven became lost to follow-up. More patients failed among those with a CD4+cell count ≤ 50 cells/μl, 5/7 (71.4%) than those with counts above 200 cells/μl, 2/12 (16.7%), (p = 0.005).
conclusionPentamidine secondary prophylaxis led to a 29% failure rate within one year, much lower than reported in historical controls (50%-100%). Patients with low CD4+cell counts are at increased risk of relapse despite effective initial VL treatment, ART and secondary prophylaxis. VL should be detected and treated early enough in patients with HIV infection before profound immune deficiency installs.
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