Resposta ao tratamento para leishmaniose visceral em pacientes coinfectados por Leishmania/HIV
DOI:
https://doi.org/10.18378/rebes.v13i3.9827Resumen
A Leishmaniose Visceral (LV) em pacientes imunossuprimidos pelo vírus da imunodeficiência humana (HIV) costuma ser uma doença oportunista grave. O manejo da LV em pessoas vivendo com HIV (PVHIV) é desafiador, uma vez que esses pacientes apresentam uma má resposta ao tratamento antileishmania, com risco de evolução crônica e alta taxa de recidiva da LV. Este estudo tem como objetivo descrever a resposta ao tratamento antileishmania nos pacientes coinfectados por Leishmania/HIV, destacando os fatores que dificultam o manejo adequado da LV e as alternativas de tratamento capazes de melhorar a resposta desses pacientes à terapia antileishmania. Trata-se de uma pesquisa bibliográfica conduzida nas bases de dados MEDLINE, LILACS, EMBASE, SCOPUS e SCIENCE DIRECT, tendo sido incluídos artigos publicados entre 2017 e 2023, com temática pertinente ao objeto de estudo, sendo selecionados 16 estudos para serem discutidos. Os estudos apontam que os principais fatores associados à má resposta ao tratamento da LV em PVHIV são a dificuldade de se atingir a concentração adequada dos fármacos antileishmania no organismo desses pacientes, falta de profilaxia secundária, ausência de terapia antirretrovial (TARV) efetiva, recidiva prévia da LV, baixa imunidade, coinfecção com tuberculose e mau estado nutricional. A administração de fármacos antileishmania em regime combinado ao invés de monoterapia, juntamente com o início precoce da TARV e a instituição de uma profilaxia secundária podem melhorar o desfecho da LV nos pacientes coinfectados por Leishmania/HIV. No entanto, o tratamento efetivo para a LV nesses pacientes ainda é um desafio, sendo necessário encontrar formas mais eficazes de melhorar a resposta terapêutica.
Palavras-chave: Leishmaniose visceral. Infecção por HIV. Tratamento antileishmania. Terapia combinada.
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Derechos de autor 2023 Marianny da Silva Barreto, Ana Leticia Lira Paulino, Maria Clara Sousa Evangelista Vieira, TATIANA PASCHOALETTE RODRIGUES BACHUR
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
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