IDEAS home Printed from https://ideas.repec.org/a/plo/pntd00/0002195.html
   My bibliography  Save this article

Efficacy of Anti-Leishmania Therapy in Visceral Leishmaniasis among HIV Infected Patients: A Systematic Review with Indirect Comparison

Author

Listed:
  • Gláucia F Cota
  • Marcos R de Sousa
  • Tatiani Oliveira Fereguetti
  • Ana Rabello

Abstract

Objective: We conducted a systematic literature review with indirect comparison of studies evaluating therapeutic efficacy and toxicity associated to visceral leishmaniasis (VL) therapy among HIV infected individuals. Main outcome measurements: The outcomes of interest were clinical and parasitological cure, mortality, and adverse events. Methods: PRISMA guidelines for systematic reviews and Cochrane manual were followed. Sources were MEDLINE, LILACS, EMBASE, Web of Knowledge databases and manual search of references from evaluated studies. We included all studies reporting outcomes after VL treatment, regardless of their design. Study quality was evaluated systematically by using the Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analyses. Comprehensive Meta-Analysis software v.2.2.048 was used to perform one-group meta-analysis of study arms with the same drug to estimate global rates of success and adverse events with each drug. These estimates were used, when possible, to indirectly compare treatment options, adjusted for CD4 count. Direct comparison was pooled when available. Results: Seventeen studies reporting five treatment regimens and outcome of 920 VL episodes occurring in HIV infected individuals were included. The main outstanding difference in outcome among the treatment regimens was observed in mortality rate: it was around 3 times higher with high-dose antimony use (18.4%, CI 95% 13.3–25%), indirectly compared to lipid formulations of amphotericin B treatment (6.1%, CI 95% 3.9–9.4%). It was observed, also by indirect comparison, higher rates of clinical improvement in study arms using amphotericin B than in study arms using pentavalent antimonial therapy (Sbv). The parasitological cure, an outcome that presented some degree of risk of selection and verification bias, had rates that varied widely within the same treatment arm, with high heterogeneity, hampering any formal comparison among drugs. One direct comparison of amphotericin and antimoniate was possible combining results of two studies and confirming the superiority of amphotericin. Conclusions: Available evidence suggests that amphotericin is superior to antimony treatment. Death rate using antimoniate high dose is unacceptably high. Randomized controlled trials are necessary to compare different formulations and doses of amphotericin, alternative therapies and drug combinations. Author Summary: In co-infection with HIV/AIDS, visceral leishmaniasis (VL) most often results in an unfavorable response to treatment, frequent relapses, and in premature deaths. Scarce data is available regarding the treatment of leishmaniasis in HIV-infected patients (VL-HIV). Despite this, clinical decisions must be made. To aid in this task we reviewed comprehensive and systematically the available literature about efficacy and toxicity of therapeutic options for VL-HIV. PRISMA guidelines and Cochrane manual for systematic reviews were followed. Direct and indirect comparisons of nonrandomized studies were used, adjusting for CD4 count. Seventeen studies reporting five treatment regimens and outcome of 920 VL episodes occurring in HIV infected individuals were included. Results suggest higher survival and clinical response rate with amphotericin B than with antimony treatment. Antimonial therapy carries a higher rate of drug discontinuation and a significantly higher mortality indirectly compared to treatment with amphotericin B. Randomized controlled trials are needed to compare doses and formulations of amphotericin and alternative treatments.

Suggested Citation

  • Gláucia F Cota & Marcos R de Sousa & Tatiani Oliveira Fereguetti & Ana Rabello, 2013. "Efficacy of Anti-Leishmania Therapy in Visceral Leishmaniasis among HIV Infected Patients: A Systematic Review with Indirect Comparison," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 7(5), pages 1-13, May.
  • Handle: RePEc:plo:pntd00:0002195
    DOI: 10.1371/journal.pntd.0002195
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0002195
    Download Restriction: no

    File URL: https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0002195&type=printable
    Download Restriction: no

    File URL: https://libkey.io/10.1371/journal.pntd.0002195?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Alessandro Liberati & Douglas G Altman & Jennifer Tetzlaff & Cynthia Mulrow & Peter C Gøtzsche & John P A Ioannidis & Mike Clarke & P J Devereaux & Jos Kleijnen & David Moher, 2009. "The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies That Evaluate Health Care Interventions: Explanation and Elaboration," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-28, July.
    2. Sarah Donegan & Paula Williamson & Carrol Gamble & Catrin Tudur-Smith, 2010. "Indirect Comparisons: A Review of Reporting and Methodological Quality," PLOS ONE, Public Library of Science, vol. 5(11), pages 1-11, November.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Tripathy, Prajukta & Jena, Pabitra Kumar & Mishra, Bikash Ranjan, 2024. "Systematic literature review and bibliometric analysis of energy efficiency," Renewable and Sustainable Energy Reviews, Elsevier, vol. 200(C).
    2. Elizabeth T Cafiero-Fonseca & Andrew Stawasz & Sydney T Johnson & Reiko Sato & David E Bloom, 2017. "The full benefits of adult pneumococcal vaccination: A systematic review," PLOS ONE, Public Library of Science, vol. 12(10), pages 1-23, October.
    3. Ludoviko Zirimenya & Fatima Mahmud-Ajeigbe & Ruth McQuillan & You Li, 2020. "A systematic review and meta-analysis to assess the association between urogenital schistosomiasis and HIV/AIDS infection," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 14(6), pages 1-13, June.
    4. Trang Nguyen & Sara Holton & Thach Tran & Jane Fisher, 2019. "Informal mental health interventions for people with severe mental illness in low and lower middle-income countries: A systematic review of effectiveness," International Journal of Social Psychiatry, , vol. 65(3), pages 194-206, May.
    5. Natalya Ivanova & Ekaterina Zolotova, 2023. "Landolt Indicator Values in Modern Research: A Review," Sustainability, MDPI, vol. 15(12), pages 1-22, June.
    6. Su Keng Tan & Wai Keung Leung & Alexander Tin Hong Tang & Roger A Zwahlen, 2017. "Effects of mandibular setback with or without maxillary advancement osteotomies on pharyngeal airways: An overview of systematic reviews," PLOS ONE, Public Library of Science, vol. 12(10), pages 1-20, October.
    7. Vecchio, Riccardo & Caso, Gerarda & Cembalo, Luigi & Borrello, Massimiliano, 2020. "Is respondents’ inattention in online surveys a major issue for research?," Economia agro-alimentare / Food Economy, Italian Society of Agri-food Economics/Società Italiana di Economia Agro-Alimentare (SIEA), vol. 22(01), March.
    8. Alessandro Concari & Gerjo Kok & Pim Martens, 2020. "A Systematic Literature Review of Concepts and Factors Related to Pro-Environmental Consumer Behaviour in Relation to Waste Management Through an Interdisciplinary Approach," Sustainability, MDPI, vol. 12(11), pages 1-50, May.
    9. Damiano Pizzol & Mike Trott & Igor Grabovac & Mario Antunes & Anna Claudia Colangelo & Simona Ippoliti & Cristian Petre Ilie & Anne Carrie & Nicola Veronese & Lee Smith, 2021. "Laparoscopy in Low-Income Countries: 10-Year Experience and Systematic Literature Review," IJERPH, MDPI, vol. 18(11), pages 1-11, May.
    10. Yehuda Weizman & Oren Tirosh & Jeanie Beh & Franz Konstantin Fuss & Sonja Pedell, 2021. "Gait Assessment Using Wearable Sensor-Based Devices in People Living with Dementia: A Systematic Review," IJERPH, MDPI, vol. 18(23), pages 1-14, December.
    11. Alessandro Margherita & Emanuele Banchi & Alfredo Biffi & Gianluca di Castri & Rocco Morelli, 2022. "Beyond Total Cost Management (TCM) to Systemic Value Management (SVM): Transformational Trends and a Research Manifesto for an Evolving Discipline," Sustainability, MDPI, vol. 14(19), pages 1-16, October.
    12. Stefano D’Angelo & Angelo Cavallo & Antonio Ghezzi & Francesco Di Lorenzo, 2024. "Understanding corporate entrepreneurship in the digital age: a review and research agenda," Review of Managerial Science, Springer, vol. 18(12), pages 3719-3774, December.
    13. Fabio Magnacca & Riccardo Giannetti, 2024. "Management accounting and new product development: a systematic literature review and future research directions," Journal of Management & Governance, Springer;Accademia Italiana di Economia Aziendale (AIDEA), vol. 28(2), pages 651-685, June.
    14. Jacob Elnaggar & Fern Tsien & Lucio Miele & Chindo Hicks & Clayton Yates & Melisa Davis, 2019. "An Integrative Genomics Approach for Associating Genetic Susceptibility with the Tumor Immune Microenvironment in Triple Negative Breast Cancer," Biomedical Journal of Scientific & Technical Research, Biomedical Research Network+, LLC, vol. 15(1), pages 1-12, February.
    15. Michael Masaracchio & William J Hanney & Xinliang Liu & Morey Kolber & Kaitlin Kirker, 2017. "Timing of rehabilitation on length of stay and cost in patients with hip or knee joint arthroplasty: A systematic review with meta-analysis," PLOS ONE, Public Library of Science, vol. 12(6), pages 1-22, June.
    16. Evans, Rhiannon & White, James & Turley, Ruth & Slater, Thomas & Morgan, Helen & Strange, Heather & Scourfield, Jonathan, 2017. "Comparison of suicidal ideation, suicide attempt and suicide in children and young people in care and non-care populations: Systematic review and meta-analysis of prevalence," Children and Youth Services Review, Elsevier, vol. 82(C), pages 122-129.
    17. Yi Ouyang & Ping-Chao Lee & Ling-Mei Ko, 2022. "A Systematic Review of the Development of Sport Policy Research (2000–2020)," Sustainability, MDPI, vol. 15(1), pages 1-22, December.
    18. Juliane Piasseschi de Bernardin Gonçalves & Giancarlo Lucchetti & Paulo Rossi Menezes & Homero Vallada, 2017. "Complementary religious and spiritual interventions in physical health and quality of life: A systematic review of randomized controlled clinical trials," PLOS ONE, Public Library of Science, vol. 12(10), pages 1-21, October.
    19. Milou van Heuckelum & Cornelia H M van den Ende & Anne E J Houterman & Charlotte P M Heemskerk & Sandra van Dulmen & Bart J F van den Bemt, 2017. "The effect of electronic monitoring feedback on medication adherence and clinical outcomes: A systematic review," PLOS ONE, Public Library of Science, vol. 12(10), pages 1-18, October.
    20. Caroline A Bulstra & Jan A C Hontelez & Moritz Otto & Anna Stepanova & Erik Lamontagne & Anna Yakusik & Wafaa M El-Sadr & Tsitsi Apollo & Miriam Rabkin & UNAIDS Expert Group on Integration & Rifat Atu, 2021. "Integrating HIV services and other health services: A systematic review and meta-analysis," PLOS Medicine, Public Library of Science, vol. 18(11), pages 1-31, November.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pntd00:0002195. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosntds (email available below). General contact details of provider: https://journals.plos.org/plosntds/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.