Five-year retrospective italian multicenter study of visceral leishmaniasis treatment
| Autor: | Giuseppe Foti, Giovanni Todaro, Giustino Parruti, Evangelista Sagnelli, Francesco Mazzotta, Giacomo Zanelli, Nicola Acone, Lamberto Manzoli, Angelo Casabianca, Leonardo Chianura, R. Russo, L. Nigro, Maria Donata Iannece, Giacinta Tordini, Marazzi Mg, Nunzio Storaci, Eligio Pizzigallo, Simona Migliore, Ennio Polilli, Francesco Baldasso, Paolo Almi, Pietro Di Gregorio, Francesco Di Masi, Claudia Colomba, Tamara Ursini, Giovanni Cenderello |
|---|---|
| Přispěvatelé: | Di Masi, F., Ursini, T., Iannece, M., Chianura, L., Baldasso, F., Foti, G., Di Gregorio, P., Casabianca, A., Storaci, N., Nigro, L., Colomba, C., Marazzi, M., Todaro, G., Tordini, G., Zanelli, G., Cenderello, G., Ancone, N., Polilli, E., Migliore, S., Almi, P., Pizzigallo, E., Sagnelli, E., Mazzotta, F., Russo, R., Manzoli, L., Parruti, G. |
| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
Adult
Male medicine.medical_specialty Settore MED/17 - Malattie Infettive Adolescent Antiprotozoal Agents Socio-culturale Clinical Therapeutics Aged Amphotericin B Child Female Humans Italy Leishmaniasis Visceral Middle Aged Retrospective Studies Treatment Outcome Young Adult Pharmacology (medical) Pharmacology Infectious Diseases Internal medicine medicine Young adult visceral leishmaniasis treatment Italy Leishmaniasis Visceral business.industry Ambientale Retrospective cohort study medicine.disease Surgery Visceral leishmaniasis Multicenter study Liposomal amphotericin Outcome data business After treatment medicine.drug |
| Popis: | The treatment of visceral leishmaniasis (VL) is poorly standardized in Italy in spite of the existing evidence. All consecutive patients with VL admitted at 15 Italian centers as inpatients or outpatients between January 2004 and December 2008 were retrospectively considered; outcome data at 1 year after treatment were obtained for all but 1 patient. Demographic characteristics, underlying diseases, diagnostic procedures, treatment regimens and outcomes, as well as side effects were recorded. A confirmed diagnosis of VL was reported for 166 patients: 120 (72.3%) immunocompetent, 21 (12.6%) patients with immune deficiencies other than HIV infection, and 25 (15.1%) coinfected with HIV. Liposomal amphotericin B (L-AmB) was the drug almost universally used for treatment, administered to 153 (92.2%) patients. Thirty-seven different regimens, including L-AmB were used. The mean doses were 29.4 ± 7.9 mg/kg in immunocompetent patients, 32.9 ± 8.6 mg/kg in patients with non-HIV-related immunodeficiencies, and 40.8 ± 6.7 mg/kg in HIV-infected patients ( P < 0.001). The mean numbers of infusion days were 7.8 ± 3.1 in immunocompetent patients, 9.6 ± 3.9 in non-HIV-immunodeficient patients, and 12.0 ± 3.4 in HIV-infected patients ( P < 0.001). Mild and reversible adverse events were observed in 12.2% of cases. Responsive patients were 154 (93.3%). Successes were 98.4% among immunocompetent patients, 90.5% among non-HIV-immunodeficient patients, and 72.0% among HIV-infected patients. Among predictors of primary response to treatment, HIV infection and age held independent associations in the final multivariate models, whereas the doses and duration of L-AmB treatment were not significantly associated. Longer treatments and higher doses of L-AmB were not able to significantly modify treatment outcomes either in the immunocompetent or in the immunocompromised population. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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