Use of Pentamidine As Secondary Prophylaxis to Prevent Visceral Leishmaniasis Relapse in HIV Infected Patients, the First Twelve Months of a Prospective Cohort Study
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{"title"=>"Use of Pentamidine As Secondary Prophylaxis to Prevent Visceral Leishmaniasis Relapse in HIV Infected Patients, the First Twelve Months of a Prospective Cohort Study", "type"=>"journal", "authors"=>[{"first_name"=>"Ermias", "last_name"=>"Diro", "scopus_author_id"=>"16024203000"}, {"first_name"=>"Koert", "last_name"=>"Ritmeijer", "scopus_author_id"=>"6507541503"}, {"first_name"=>"Marleen", "last_name"=>"Boelaert", "scopus_author_id"=>"7005040188"}, {"first_name"=>"Fabiana", "last_name"=>"Alves", "scopus_author_id"=>"57139853100"}, {"first_name"=>"Rezika", "last_name"=>"Mohammed", "scopus_author_id"=>"56192332100"}, {"first_name"=>"Charles", "last_name"=>"Abongomera", "scopus_author_id"=>"57140800600"}, {"first_name"=>"Raffaella", "last_name"=>"Ravinetto", "scopus_author_id"=>"6506438376"}, {"first_name"=>"Maaike", "last_name"=>"De Crop", "scopus_author_id"=>"55566515000"}, {"first_name"=>"Helina", "last_name"=>"Fikre", "scopus_author_id"=>"57140803600"}, {"first_name"=>"Cherinet", "last_name"=>"Adera", "scopus_author_id"=>"57140836900"}, {"first_name"=>"Robert", "last_name"=>"Colebunders", "scopus_author_id"=>"35301739400"}, {"first_name"=>"Harry", "last_name"=>"van Loen", "scopus_author_id"=>"23570257000"}, {"first_name"=>"Joris", "last_name"=>"Menten", "scopus_author_id"=>"23569794800"}, {"first_name"=>"Lutgarde", "last_name"=>"Lynen", "scopus_author_id"=>"55403459200"}, {"first_name"=>"Asrat", "last_name"=>"Hailu", "scopus_author_id"=>"7003570205"}, {"first_name"=>"Johan", "last_name"=>"van Griensven", "scopus_author_id"=>"16644465400"}], "year"=>2015, "source"=>"PLoS Neglected Tropical Diseases", "identifiers"=>{"issn"=>"19352735", "scopus"=>"2-s2.0-84959107119", "sgr"=>"84959107119", "pui"=>"608551754", "isbn"=>"1935-2735", "pmid"=>"26431253", "doi"=>"10.1371/journal.pntd.0004087"}, "id"=>"d6393240-3afe-372a-ba9a-62cb51344f53", "abstract"=>"BACKGROUND: Visceral leishmaniasis (VL) has become an important opportunistic infection in persons with HIV-infection in VL-endemic areas. The co-infection leads to profound immunosuppression and high rate of annual VL recurrence. This study assessed the effectiveness, safety and feasibility of monthly pentamidine infusions to prevent recurrence of VL in HIV co-infected patients.\\n\\nMETHODS: A single-arm, open-label trial was conducted at two leishmaniasis treatment centers in northwest Ethiopia. HIV-infected patients with a VL episode were included after parasitological cure. Monthly infusions of 4mg/kg pentamidine-isethionate diluted in normal-saline were started for 12months. All received antiretroviral therapy (ART). Time-to-relapse or death was the primary end point.\\n\\nRESULTS: Seventy-four patients were included. The probability of relapse-free survival at 6months and at 12 months was 79% and 71% respectively. Renal failure, a possible drug-related serious adverse event, occurred in two patients with severe pneumonia. Forty-one patients completed the regimen taking at least 11 of the 12 doses. Main reasons to discontinue were: 15 relapsed, five died and seven became lost to follow-up. More patients failed among those with a CD4+cell count ≤ 50cells/μl, 5/7 (71.4%) than those with counts above 200 cells/μl, 2/12 (16.7%), (p = 0.005).\\n\\nCONCLUSION: Pentamidine secondary prophylaxis led to a 29% failure rate within one year, much lower than reported in historical controls (50%-100%). Patients with low CD4+cell counts are at increased risk of relapse despite effective initial VL treatment, ART and secondary prophylaxis. VL should be detected and treated early enough in patients with HIV infection before profound immune deficiency installs.", "link"=>"http://www.mendeley.com/research/pentamidine-secondary-prophylaxis-prevent-visceral-leishmaniasis-relapse-hiv-infected-patients-first", "reader_count"=>41, "reader_count_by_academic_status"=>{"Unspecified"=>3, "Researcher"=>9, "Student > Doctoral Student"=>4, "Student > Ph. D. Student"=>8, "Student > Postgraduate"=>3, "Other"=>3, "Student > Master"=>9, "Student > Bachelor"=>2}, "reader_count_by_user_role"=>{"Unspecified"=>3, "Researcher"=>9, "Student > Doctoral Student"=>4, "Student > Ph. D. Student"=>8, "Student > Postgraduate"=>3, "Other"=>3, "Student > Master"=>9, "Student > Bachelor"=>2}, "reader_count_by_subject_area"=>{"Unspecified"=>3, "Nursing and Health Professions"=>3, "Mathematics"=>1, "Medicine and Dentistry"=>18, "Agricultural and Biological Sciences"=>7, "Pharmacology, Toxicology and Pharmaceutical Science"=>4, "Veterinary Science and Veterinary Medicine"=>1, "Business, Management and Accounting"=>1, "Chemistry"=>1, "Social Sciences"=>1, "Immunology and Microbiology"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>18}, "Chemistry"=>{"Chemistry"=>1}, "Social Sciences"=>{"Social Sciences"=>1}, "Immunology and Microbiology"=>{"Immunology and Microbiology"=>1}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>7}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>3}, "Business, Management and Accounting"=>{"Business, Management and Accounting"=>1}, "Mathematics"=>{"Mathematics"=>1}, "Unspecified"=>{"Unspecified"=>3}, "Pharmacology, Toxicology and Pharmaceutical Science"=>{"Pharmacology, Toxicology and Pharmaceutical Science"=>4}, "Veterinary Science and Veterinary Medicine"=>{"Veterinary Science and Veterinary Medicine"=>1}}, "reader_count_by_country"=>{"Brazil"=>1, "South Africa"=>1}, "group_count"=>5}

Scopus | Further Information

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/2296575"], "description"=>"<p>VL–visceral leishmaniasis, ART–antiretroviral therapy</p><p>Risk factors for relapse.</p>", "links"=>[], "tags"=>["count", "HIV Infected Patients", "Visceral Leishmaniasis Relapse", "12 months", "Prospective Cohort Study BackgroundVisceral leishmaniasis", "leishmaniasis treatment centers", "vl"], "article_id"=>1562549, "categories"=>["Uncategorised"], "users"=>["Ermias Diro", "Koert Ritmeijer", "Marleen Boelaert", "Fabiana Alves", "Rezika Mohammed", "Charles Abongomera", "Raffaella Ravinetto", "Maaike De Crop", "Helina Fikre", "Cherinet Adera", "Robert Colebunders", "Harry van Loen", "Joris Menten", "Lutgarde Lynen", "Asrat Hailu", "Johan van Griensven"], "doi"=>"https://dx.doi.org/10.1371/journal.pntd.0004087.t005", "stats"=>{"downloads"=>0, "page_views"=>12, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Risk_factors_for_relapse_/1562549", "title"=>"Risk factors for relapse.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-10-02 02:49:14"}
  • {"files"=>["https://ndownloader.figshare.com/files/2296574"], "description"=>"<p>VL–visceral leishmaniasis</p><p>*two of the renal impairments occurred in patients admitted for severe pneumonia who eventually died while on treatment. But as pentamidine is also known for its renal effect, they were considered as possibly pentamidine related serious adverse events</p><p>**this patient was made to discontinue the pentamidine when he developed hyperglycemia that normalized on the next month visit. These three patients (2 with renal failures and 1 with hyperglycemia) accounted for the primary safety outcome)</p><p>Drug related adverse events.</p>", "links"=>[], "tags"=>["count", "HIV Infected Patients", "Visceral Leishmaniasis Relapse", "12 months", "Prospective Cohort Study BackgroundVisceral leishmaniasis", "leishmaniasis treatment centers", "vl"], "article_id"=>1562548, "categories"=>["Uncategorised"], "users"=>["Ermias Diro", "Koert Ritmeijer", "Marleen Boelaert", "Fabiana Alves", "Rezika Mohammed", "Charles Abongomera", "Raffaella Ravinetto", "Maaike De Crop", "Helina Fikre", "Cherinet Adera", "Robert Colebunders", "Harry van Loen", "Joris Menten", "Lutgarde Lynen", "Asrat Hailu", "Johan van Griensven"], "doi"=>"https://dx.doi.org/10.1371/journal.pntd.0004087.t004", "stats"=>{"downloads"=>1, "page_views"=>16, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Drug_related_adverse_events_/1562548", "title"=>"Drug related adverse events.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-10-02 02:49:14"}
  • {"files"=>["https://ndownloader.figshare.com/files/2296571"], "description"=>"<p>*Not measured due to ascites, IQR–Interquartile range, bpm–beats per minute, VL–visceral leishmaniasis, WBC–white blood cells</p><p>Baseline characteristics of recruited patients in three groups.</p>", "links"=>[], "tags"=>["count", "HIV Infected Patients", "Visceral Leishmaniasis Relapse", "12 months", "Prospective Cohort Study BackgroundVisceral leishmaniasis", "leishmaniasis treatment centers", "vl"], "article_id"=>1562545, "categories"=>["Uncategorised"], "users"=>["Ermias Diro", "Koert Ritmeijer", "Marleen Boelaert", "Fabiana Alves", "Rezika Mohammed", "Charles Abongomera", "Raffaella Ravinetto", "Maaike De Crop", "Helina Fikre", "Cherinet Adera", "Robert Colebunders", "Harry van Loen", "Joris Menten", "Lutgarde Lynen", "Asrat Hailu", "Johan van Griensven"], "doi"=>"https://dx.doi.org/10.1371/journal.pntd.0004087.t001", "stats"=>{"downloads"=>5, "page_views"=>12, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Baseline_characteristics_of_recruited_patients_in_three_groups_/1562545", "title"=>"Baseline characteristics of recruited patients in three groups.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-10-02 02:49:14"}
  • {"files"=>["https://ndownloader.figshare.com/files/2296569"], "description"=>"<p>Flow chart showing the recruitment process and main outcomes.</p>", "links"=>[], "tags"=>["count", "HIV Infected Patients", "Visceral Leishmaniasis Relapse", "12 months", "Prospective Cohort Study BackgroundVisceral leishmaniasis", "leishmaniasis treatment centers", "vl"], "article_id"=>1562543, "categories"=>["Uncategorised"], "users"=>["Ermias Diro", "Koert Ritmeijer", "Marleen Boelaert", "Fabiana Alves", "Rezika Mohammed", "Charles Abongomera", "Raffaella Ravinetto", "Maaike De Crop", "Helina Fikre", "Cherinet Adera", "Robert Colebunders", "Harry van Loen", "Joris Menten", "Lutgarde Lynen", "Asrat Hailu", "Johan van Griensven"], "doi"=>"https://dx.doi.org/10.1371/journal.pntd.0004087.g001", "stats"=>{"downloads"=>2, "page_views"=>13, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Flow_chart_showing_the_recruitment_process_and_main_outcomes_/1562543", "title"=>"Flow chart showing the recruitment process and main outcomes.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2015-10-02 02:49:14"}
  • {"files"=>["https://ndownloader.figshare.com/files/2296570"], "description"=>"<p>Kaplan-Meier survival estimate of the main effectiveness analysis.</p>", "links"=>[], "tags"=>["count", "HIV Infected Patients", "Visceral Leishmaniasis Relapse", "12 months", "Prospective Cohort Study BackgroundVisceral leishmaniasis", "leishmaniasis treatment centers", "vl"], "article_id"=>1562544, "categories"=>["Uncategorised"], "users"=>["Ermias Diro", "Koert Ritmeijer", "Marleen Boelaert", "Fabiana Alves", "Rezika Mohammed", "Charles Abongomera", "Raffaella Ravinetto", "Maaike De Crop", "Helina Fikre", "Cherinet Adera", "Robert Colebunders", "Harry van Loen", "Joris Menten", "Lutgarde Lynen", "Asrat Hailu", "Johan van Griensven"], "doi"=>"https://dx.doi.org/10.1371/journal.pntd.0004087.g002", "stats"=>{"downloads"=>2, "page_views"=>15, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Kaplan_Meier_survival_estimate_of_the_main_effectiveness_analysis_/1562544", "title"=>"Kaplan-Meier survival estimate of the main effectiveness analysis.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2015-10-02 02:49:14"}
  • {"files"=>["https://ndownloader.figshare.com/files/2296576", "https://ndownloader.figshare.com/files/2296577", "https://ndownloader.figshare.com/files/2296578", "https://ndownloader.figshare.com/files/2296579"], "description"=>"<div><p>Background</p><p>Visceral leishmaniasis (VL) has become an important opportunistic infection in persons with HIV-infection in VL-endemic areas. The co-infection leads to profound immunosuppression and high rate of annual VL recurrence. This study assessed the effectiveness, safety and feasibility of monthly pentamidine infusions to prevent recurrence of VL in HIV co-infected patients.</p><p>Methods</p><p>A single-arm, open-label trial was conducted at two leishmaniasis treatment centers in northwest Ethiopia. HIV-infected patients with a VL episode were included after parasitological cure. Monthly infusions of 4mg/kg pentamidine-isethionate diluted in normal-saline were started for 12months. All received antiretroviral therapy (ART). Time-to-relapse or death was the primary end point.</p><p>Results</p><p>Seventy-four patients were included. The probability of relapse-free survival at 6months and at 12 months was 79% and 71% respectively. Renal failure, a possible drug-related serious adverse event, occurred in two patients with severe pneumonia. Forty-one patients completed the regimen taking at least 11 of the 12 doses. Main reasons to discontinue were: 15 relapsed, five died and seven became lost to follow-up. More patients failed among those with a CD4+cell count ≤ 50cells/μl, 5/7 (71.4%) than those with counts above 200 cells/μl, 2/12 (16.7%), (p = 0.005).</p><p>Conclusion</p><p>Pentamidine secondary prophylaxis led to a 29% failure rate within one year, much lower than reported in historical controls (50%-100%). Patients with low CD4+cell counts are at increased risk of relapse despite effective initial VL treatment, ART and secondary prophylaxis. VL should be detected and treated early enough in patients with HIV infection before profound immune deficiency installs.</p></div>", "links"=>[], "tags"=>["count", "HIV Infected Patients", "Visceral Leishmaniasis Relapse", "12 months", "Prospective Cohort Study BackgroundVisceral leishmaniasis", "leishmaniasis treatment centers", "vl"], "article_id"=>1562550, "categories"=>["Uncategorised"], "users"=>["Ermias Diro", "Koert Ritmeijer", "Marleen Boelaert", "Fabiana Alves", "Rezika Mohammed", "Charles Abongomera", "Raffaella Ravinetto", "Maaike De Crop", "Helina Fikre", "Cherinet Adera", "Robert Colebunders", "Harry van Loen", "Joris Menten", "Lutgarde Lynen", "Asrat Hailu", "Johan van Griensven"], "doi"=>["https://dx.doi.org/10.1371/journal.pntd.0004087.s001", "https://dx.doi.org/10.1371/journal.pntd.0004087.s002", "https://dx.doi.org/10.1371/journal.pntd.0004087.s003", "https://dx.doi.org/10.1371/journal.pntd.0004087.s004"], "stats"=>{"downloads"=>3, "page_views"=>6, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Use_of_Pentamidine_As_Secondary_Prophylaxis_to_Prevent_Visceral_Leishmaniasis_Relapse_in_HIV_Infected_Patients_the_First_Twelve_Months_of_a_Prospective_Cohort_Study_/1562550", "title"=>"Use of Pentamidine As Secondary Prophylaxis to Prevent Visceral Leishmaniasis Relapse in HIV Infected Patients, the First Twelve Months of a Prospective Cohort Study", "pos_in_sequence"=>0, "defined_type"=>4, "published_date"=>"2015-10-02 02:49:14"}
  • {"files"=>["https://ndownloader.figshare.com/files/2296573"], "description"=>"<p>**Survival analysis percentages take into account that some patients were censored during the follow-up, VL–visceral leishmaniasis</p><p>Summary of Primary Effectiveness Analysis Results.</p>", "links"=>[], "tags"=>["count", "HIV Infected Patients", "Visceral Leishmaniasis Relapse", "12 months", "Prospective Cohort Study BackgroundVisceral leishmaniasis", "leishmaniasis treatment centers", "vl"], "article_id"=>1562547, "categories"=>["Uncategorised"], "users"=>["Ermias Diro", "Koert Ritmeijer", "Marleen Boelaert", "Fabiana Alves", "Rezika Mohammed", "Charles Abongomera", "Raffaella Ravinetto", "Maaike De Crop", "Helina Fikre", "Cherinet Adera", "Robert Colebunders", "Harry van Loen", "Joris Menten", "Lutgarde Lynen", "Asrat Hailu", "Johan van Griensven"], "doi"=>"https://dx.doi.org/10.1371/journal.pntd.0004087.t003", "stats"=>{"downloads"=>0, "page_views"=>13, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Summary_of_Primary_Effectiveness_Analysis_Results_/1562547", "title"=>"Summary of Primary Effectiveness Analysis Results.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-10-02 02:49:14"}
  • {"files"=>["https://ndownloader.figshare.com/files/2296572"], "description"=>"<p>VL–visceral leishmaniasis, ART–antiretroviral therapy, IQR–interquartile range, TDF–tenofovir, 3TC–lamivudine, EFV–efavirenze, AZT–zidovudine, NVP–nevirapine, D4T –didanosine, DDI–didanosine, ABC–abacavir, LPV/r–lopinavir/ritonavir</p><p>*Miltefosine and paromomycin were always used in combination with Liposomal amphotericin B and sodium stibogluconate respectively. Prolonged treatments with different regimens were also done until cure was achieved.</p><p>HIV and VL treatment history.</p>", "links"=>[], "tags"=>["count", "HIV Infected Patients", "Visceral Leishmaniasis Relapse", "12 months", "Prospective Cohort Study BackgroundVisceral leishmaniasis", "leishmaniasis treatment centers", "vl"], "article_id"=>1562546, "categories"=>["Uncategorised"], "users"=>["Ermias Diro", "Koert Ritmeijer", "Marleen Boelaert", "Fabiana Alves", "Rezika Mohammed", "Charles Abongomera", "Raffaella Ravinetto", "Maaike De Crop", "Helina Fikre", "Cherinet Adera", "Robert Colebunders", "Harry van Loen", "Joris Menten", "Lutgarde Lynen", "Asrat Hailu", "Johan van Griensven"], "doi"=>"https://dx.doi.org/10.1371/journal.pntd.0004087.t002", "stats"=>{"downloads"=>7, "page_views"=>10, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_HIV_and_VL_treatment_history_/1562546", "title"=>"HIV and VL treatment history.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-10-02 02:49:14"}

PMC Usage Stats | Further Information

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  • {"unique-ip"=>"4", "full-text"=>"3", "pdf"=>"1", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"2"}
  • {"unique-ip"=>"8", "full-text"=>"9", "pdf"=>"3", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"3"}
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  • {"unique-ip"=>"9", "full-text"=>"13", "pdf"=>"2", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"5"}
  • {"unique-ip"=>"7", "full-text"=>"7", "pdf"=>"3", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"8"}
  • {"unique-ip"=>"4", "full-text"=>"3", "pdf"=>"1", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"9"}
  • {"unique-ip"=>"9", "full-text"=>"9", "pdf"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"2", "cited-by"=>"0", "year"=>"2019", "month"=>"10"}
  • {"unique-ip"=>"9", "full-text"=>"6", "pdf"=>"4", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"12"}
  • {"unique-ip"=>"5", "full-text"=>"5", "pdf"=>"3", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2020", "month"=>"2"}
  • {"unique-ip"=>"10", "full-text"=>"11", "pdf"=>"2", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2020", "month"=>"3"}
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  • {"unique-ip"=>"10", "full-text"=>"11", "pdf"=>"3", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2020", "month"=>"6"}
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Relative Metric

{"start_date"=>"2015-01-01T00:00:00Z", "end_date"=>"2015-12-31T00:00:00Z", "subject_areas"=>[]}
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