| Title |
Leishmaniasis as an opportunistic infection in HIV-infected patients: determinants of relapse and mortality in a collaborative study of 228 episodes in a Mediterreanean region
|
|---|---|
| Published in |
European Journal of Clinical Microbiology & Infectious Diseases, June 2005
|
| DOI | 10.1007/s10096-005-1342-6 |
| Pubmed ID | |
| Authors |
F. Pasquau, J. Ena, R. Sanchez, J. M. Cuadrado, C. Amador, J. Flores, C. Benito, C. Redondo, J. Lacruz, V. Abril, J. Onofre, Leishmania HIV Mediterreanean Co-operative Group |
| Abstract |
The clinical presentation of visceral leishmaniasis shares similarities with other geographically specific infectious diseases associated with AIDS in terms of relapsing course and atypical presentation. However, visceral leishmaniasis has not, until now, been included in the AIDS case definition. The aim of this study was to describe the clinical features and determinants for relapse and case-fatality of visceral leishmaniasis in HIV-infected patients from a Spanish Mediterranean area. A chart review was conducted in 16 hospitals in the autonomous communities of Valencia and Murcia (Spain). From 1988 to 2001, a total of 228 episodes of visceral leishmaniasis were diagnosed in 155 HIV-infected patients by the detection of amastigotes in bone marrow aspirates or in other tissue samples. Most patients had advanced HIV disease, with a median CD4(+) lymphocyte cell count of 55 cells x 10(9) l, and 56% of them had a previous AIDS-indicator disease. The median duration of follow-up was 8.4 months. HIV-infected patients with visceral leishmaniasis presented with fever (76%), hepatomegaly (77%), splenomegaly (78%), and varying degrees of cytopenias. Leishmania was detected in atypical sites in 22 (14%) patients. A total of 37 (24%) patients had a relapse of visceral leishmaniasis. Female gender was a risk factor for relapse, whereas administration of secondary prophylaxis for visceral leishmaniasis and a completed therapy for visceral leishmaniasis were protective factors against relapse. A total of 86 (54%) patients died. Independent determinants for survival were CD4(+) lymphocyte cell count, completed therapy for leishmania, and secondary prophylaxis for visceral leishmaniasis. The findings show that, in HIV-infected patients, visceral leishmaniasis occurs in late stages of HIV disease and often has a relapsing course. Secondary prophylaxis reduces the risk of relapse. Visceral leishmaniasis in the HIV-infected population should be included in the CDC clinical category C for the definition of AIDS in the same way that other geographically specific opportunistic infections are included. |
Mendeley readers
The data shown below were compiled from readership statistics for 73 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| France | 1 | 1% |
| Unknown | 72 | 99% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Ph. D. Student | 11 | 15% |
| Researcher | 11 | 15% |
| Student > Bachelor | 8 | 11% |
| Student > Doctoral Student | 5 | 7% |
| Student > Master | 5 | 7% |
| Other | 11 | 15% |
| Unknown | 22 | 30% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 21 | 29% |
| Agricultural and Biological Sciences | 10 | 14% |
| Biochemistry, Genetics and Molecular Biology | 6 | 8% |
| Nursing and Health Professions | 3 | 4% |
| Immunology and Microbiology | 2 | 3% |
| Other | 9 | 12% |
| Unknown | 22 | 30% |
Attention Score in Context
This research output has an Altmetric Attention Score of 6. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 08 June 2022.
All research outputs
#4,696,396
of 22,788,370 outputs
Outputs from European Journal of Clinical Microbiology & Infectious Diseases
#418
of 2,769 outputs
Outputs of similar age
#10,419
of 57,224 outputs
Outputs of similar age from European Journal of Clinical Microbiology & Infectious Diseases
#3
of 11 outputs
Altmetric has tracked 22,788,370 research outputs across all sources so far. Compared to these this one has done well and is in the 76th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 2,769 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.6. This one has done well, scoring higher than 80% of its peers.
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We're also able to compare this research output to 11 others from the same source and published within six weeks on either side of this one. This one is in the 45th percentile – i.e., 45% of its contemporaries scored the same or lower than it.