Progress in the treatment of a neglected infectious disease: visceral leishmaniasis.

Abstract

Visceral leishmaniasis (kala-azar) is a disseminated intracellular protozoal infection. Most cases (90%) occur in the rural regions of five countries: India, Sudan, Nepal, Bangladesh and Brazil. As with other infectious diseases embedded in high-level poverty, developing and/or delivering new treatments for visceral leishmaniasis had been painfully slow or nonexistent. However, despite persistent unresolved obstacles (e.g., drug affordability), renewed interest in visceral leishmaniasis and numerous successful treatment trials have combined to turn a therapeutic corner in the past 5 years, yielding new alternatives to conventional pentavalent antimony. Advances include the use of low-cost generic pentavalent antimony, rediscovery of amphotericin B, short-course regimens via lipid formulations of amphotericin B, retesting injectible paromyomycin and, of clear-cut importance, identifying miltefosine (Impavido, Zentaris) as the first effective oral therapy for this neglected disease.

• Authors: Henry W Murray
• Journal: Expert review of anti-infective therapy (Expert Rev Anti Infect Ther) Vol. 2 Issue 2 Pg. 279-92 (Apr 2004) ISSN: 1478-7210 [Print] England
• PMID: 15482193 (Publication Type: Journal Article, Research Support, U.S. Gov't, P.H.S., Review)

Chemical References

• Antiprotozoal Agents
• Drug Combinations
• Phosphatidylcholines
• Phosphatidylglycerols
• liposomal amphotericin B
• Deoxycholic Acid
• Phosphorylcholine
• miltefosine
• Paromomycin
• Amphotericin B
• amphotericin B, deoxycholate drug combination
• Antimony

Topics

• Amphotericin B (economics, therapeutic use)
• Antimony (economics, therapeutic use)
• Antiprotozoal Agents (economics, supply & distribution, therapeutic use)
• Clinical Trials as Topic
• Deoxycholic Acid (economics, therapeutic use)
• Drug Combinations
• Drug Costs
• Humans
• Leishmaniasis, Visceral (drug therapy, economics)
• Paromomycin (economics, therapeutic use)
• Phosphatidylcholines (economics, therapeutic use)
• Phosphatidylglycerols (economics, therapeutic use)
• Phosphorylcholine (analogs & derivatives, economics, therapeutic use)
• Practice Guidelines as Topic