Subject(s)
Parasitic Diseases , Travel , Tropical Climate , Tropical Medicine , Humans , Risk FactorsABSTRACT
Oral miltefosine was administered to 39 human immunodeficiency virus (HIV)-infected patients with leishmaniasis for whom standard leishmaniasis treatment had failed. Initial response was achieved in 25 patients (64%), including 16 patients (43%) with initial parasitological cure. Repeated responses after relapse and tolerability of long courses of treatment indicate the potential for development of optimized dosage schemes.
Subject(s)
Antiprotozoal Agents/administration & dosage , HIV Infections/complications , Leishmaniasis/drug therapy , Leishmaniasis/etiology , Phosphorylcholine/analogs & derivatives , Administration, Oral , Adult , Female , Humans , Immunocompromised Host , Leishmaniasis/immunology , Male , Middle Aged , Phosphorylcholine/administration & dosageABSTRACT
Hexadecylphosphocholine (HDPC, Miltefosine, Impavido) was synthesized at the Max-Planck-Institut für Biophysikalische Chemie in Göttingen, Germany and successfully used for the therapy of cancer metastases. At the Institute of General and Tropical Hygiene of Göttingen University the antiparasitic efficacy--earlier mentioned by Croft et al. (1987)--could be established for the first time in animals after oral administration. In India Impavido has been recently registered for the treatment of visceral leishmaniasis as the first oral medication in this indication. Clinical studies in India--actually a phase IV study is running--and Columbia (cutaneous leishmaniosis) demonstrated the excellent efficacy of this oral treatment also in patients with Antimon resistance. The cure rates are above 90% with low side effects (Impavido twice 50 mg capsules daily over 28 days).
Subject(s)
Antiprotozoal Agents/therapeutic use , Leishmaniasis/drug therapy , Phosphorylcholine/analogs & derivatives , Phosphorylcholine/therapeutic use , Administration, Oral , Adult , Antiprotozoal Agents/administration & dosage , Antiprotozoal Agents/adverse effects , Child , Clinical Trials as Topic , Drug Resistance , Humans , Leishmaniasis, Cutaneous/drug therapy , Leishmaniasis, Visceral/drug therapy , Meta-Analysis as Topic , Phosphorylcholine/administration & dosage , Phosphorylcholine/adverse effects , Recurrence , Treatment OutcomeABSTRACT
A 27-year-old female primatologist returned from a trip to Peru with painful swellings on the right jaw, the mandible and at the axillary gland. Later on her right upper arm and forearm showed big, painful swellings with reddish stripes, while the former swellings gradually disappeared. Finally the back of the right hand, the right forefinger and the left forearm showed the same swellings. Diagnosis was established by the evidence of special antibodies against Gnathostoma spinigerum. Two courses of a 4-week treatment with albendazole cured the patient.
