Influence ofLeishmania (Viannia)Species on the Response to Antimonial Treatment in Patients with American Tegumentary Leishmaniasis
| Autor: | Jean-Claude Dujardin, and Alejandro Llanos‐Cuentas, Raúl Loayza-Muro, Luis Eduardo Ramirez, Simonne De Doncker, Vanessa Adaui, Marcela Lazo, Mirko Zimic, Gianfranco Tulliano, Jorge Arevalo, Cesar Miranda-Verastegui, François Chappuis, Anne Maurer |
|---|---|
| Rok vydání: | 2007 |
| Předmět: |
Antimony
medicine.medical_specialty Meglumine antimoniate Leishmania guyanensis Antiprotozoal Agents America Latin Leishmaniasis Cutaneous Polymerase Chain Reaction Gastroenterology Meglumine Species Specificity Tegumentary Cutaneous leishmaniasis Internal medicine Peru parasitic diseases Organometallic Compounds medicine Animals Humans Immunology and Allergy Treatment Failure Treatment outcome Leishmaniasis Determinants Leishmania Meglumine Antimoniate Geography biology Antimonials Kinetoplastida Protozoal diseases biology.organism_classification medicine.disease Chemotherapy regimen Cutaneous Infectious Diseases Immunology Antimonial Drug therapy Polymorphism Restriction Fragment Length medicine.drug |
| Zdroj: | The Journal of Infectious Diseases. 195:1846-1851 |
| ISSN: | 1537-6613 0022-1899 |
| Popis: | Background. Pentavalent antimonials (Sb v ) are the first-line chemotherapy for American tegumentary leishmaniasis (ATL). There are, however, reports of the occurrence of treatment failure with these drugs. Few studies in Latin America have compared the response to Sb v treatment in ATL caused by different Leishmania species. Methods. Clinical parameters and response to Sb' chemotherapy were studied in 103 patients with cutaneous leishmaniasis (CL) in Peru. Leishmania isolates were collected before treatment and typed by multilocus polymerase-chain-reaction restriction fragment-length polymorphism analysis. Results. The 103 isolates were identified as L. (Viannia) peruviana (47.6%), L. (V.) guyanensis (23.3%), L. (V.) braziliensis (22.3%), L. (V.) lainsoni (4.9%), L. (Leishmania) mexicana (1%), and a putative hybrid, L. (V.) braziliensis/L. (V.) peruviana (1%). L. (V.) guyanensis was most abundant in central Peru. Of patients infected with the 3 former species, 21 (21.9%) did not respond to Sb v chemotherapy. The proportions of treatment failure (after 12 months of follow-up) were 30.4%, 24.5%, and 8.3% in patients infected with L. (V.) braziliensis, L. (V.) peruviana, and L. (V.) guyanensis, respectively. Infection with L. (V.) guyanensis was associated with significantly less treatment failure than L. (V.) braziliensis, as determined by multiple logistic regression analysis (odds ratio, 0.07 [95% confidence interval, 0.007-0.8]; P = .03). Conclusions. Leishmania species can influence Sb' treatment outcome in patients with CL. Therefore, parasite identification is of utmost clinical importance, because it should lead to a species-oriented treatment. |
| Databáze: | OpenAIRE |
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