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- W2013167678 abstract "The excellent paper by Mueller et al. (2007) gives us an idea of how difficult it is to perform clinical research in field conditions, however I believe that their final recommendation for the use of combined antileishmanial therapy could not be drawn from their study. They have seen that a group of failing patients to AmBisome—after a previous relapse with antimonials—do respond to a second course of antimonials. They therefore recommend combined or sequential therapy with both drugs in relapse cases. HIV co-infected patients tend to have a higher parasite burden, lower positive serology rates, frequent relapses and a protracted course, despite different and multiple antileishmanial therapies (Alvar et al., 1997). Very immunocompromised HIV patients with visceral leishmaniasis have amastigotes in their bone marrow, skin and other tissues, even when they do not have clinically overt kala-azar. For these cases, addition of effective antiretroviral therapy is pivotal for immune restoration and parasite clearance (Russo et al., 2003). It is very likely that most of the failing patients to AmBisome in Mueller et al.'s study were co-infected with HIV: they had a higher parasite burden, lower positive serology rates, had had a relapse and showed a protracted course. Unfortunately, HIV testing could not be performed in six of the patients owing to the extremely difficult field conditions." @default.
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- W2013167678 date "2007-10-01" @default.
- W2013167678 modified "2023-09-25" @default.
- W2013167678 title "Comment on: Unresponsiveness to AmBisome in some Sudanese patients with kala-azar" @default.
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- W2013167678 doi "https://doi.org/10.1016/j.trstmh.2007.04.012" @default.
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