Clinical characteristics and treatment outcome of patients with visceral leishmaniasis and HIV co-infection in northwest Ethiopia

objectives To describe the clinical presentation of patients with visceral leishmaniasis (VL) with

and without human immunodeficiency virus (HIV) co-infection and factors associated with poor

outcome in northwest Ethiopia.

method Retrospective review of 241 patients with VL (92 with and 149 without HIV co-infection).

results HIV co-infection was present in 92 (38%) of the patients. Clinical presentation of VL was

indistinguishable between patients with and without HIV co-infection. Co-infected patients had a poorer

outcome i.e. either death or treatment failure (31.5% vs. 5.6%, P < 0.001). The presence of tuberculosis

or sepsis syndrome among patients with VL and HIV co-infected independently predicted death or

treatment failure [odds ratio 4.5 (95% CI 1.47–13.92, P = 0.009) and 9.1 (95% CI 2.16–37.97,

P = 0.003), respectively]. Despite having similar clinical presentation at the time of diagnosis, VL and

HIV co-infected patients had a higher mortality and treatment failure than immunocompetent patients.

conclusion The frequency of HIV co-infection among patients with VL is high in the study area, and

this co-infection was associated with death or treatment failure. The clinical management of VL in HIV

co-infected patients is a major challenge that requires new treatment approaches to improve its outcome