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Treatment of Visceral Leishmaniasis

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The Leishmaniases: Old Neglected Tropical Diseases

Abstract

All persons with symptomatic visceral leishmaniasis (VL) should be treated with antileishmanial drugs. The therapeutic options for VL are diverse and depend on different factors, such as geographical area of the infection; the Leishmania species involved, the development of failure to habitual treatment, the evidence of HIV co-infection or other infections and the presence of malnourishment. The traditional treatment of VL used to be pentavalent antimonials, but the development of resistance, as their potential toxicity, made necessary new treatment options such as amphotericin B deoxycholate or lipid formulations of amphotericin B which due to their efficacy and lower toxicity have become the first-choice treatment in different world areas. In countries of fewer resources, studies have been carried out demonstrating the efficacy of parenteral paromomycin. Within the range of oral treatments, miltefosine had demonstrated very good cure rates; however, currently, also a high rate of clinical failures has been reported. In this chapter we provide a review on the treatment of VL and give therapeutic options with the grade of recommendation according to the Leishmania implicated and the geographical location of the infection.

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Authors and Affiliations

  1. National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRICYS, Madrid, Spain

    Begoña Monge-Maillo & Rogelio López-Vélez

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  1. Begoña Monge-Maillo
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  2. Rogelio López-Vélez
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Correspondence to Rogelio López-Vélez .

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  1. Department of Translational Research, University di Pisa, Pisa, Italy

    Fabrizio Bruschi

  2. Department of Infectious Diseases, Istituto Superiore di Sanità, Roma, Italy

    Luigi Gradoni

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Monge-Maillo, B., López-Vélez, R. (2018). Treatment of Visceral Leishmaniasis. In: Bruschi, F., Gradoni, L. (eds) The Leishmaniases: Old Neglected Tropical Diseases. Springer, Cham. https://doi.org/10.1007/978-3-319-72386-0_8

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