Chemotherapy Used in the Treatment of Visceral Leishmaniasis

María Elizabeth Márquez Contreras

Laboratorio de Enzimología de Parasitos, Universidad de Los Andes, Mérida, Venezuela

Dr. María Elizabeth Márquez Contreras, Laboratorio de Enzimología de Parásitos, Universidad de Los Andes, Mérida, Venezuela. E-mail: <a

Keywords: Chemotherapy; Visceral Leishmaniasis; Multidrug Therapy

Abstract

Visceral leishmaniasis (VL) is a disease caused by an obligate intracellular protozoan belonging to the Leishmania donovani complex, which affects the reticuloendothelial system of mammals. Transmission is done through the bite of female Phlebotomus in the Old World and Lutzomyia in the New World contaminated with Leishmania. Worldwide there are an estimated incidence of 50,000-90,000 new cases of VL in the year 2017, located mainly in India, Sudan, Kenya, Somalia, Ethiopia, Brazil and South Sudan, with an estimated mortality rate of 20.000 individuals per year. The Global Burden of Disease Study (GBD) (2016) determined that the disability-adjusted life year (DALY) was 61.1% for VL. This infection has been treated for many years with various chemotherapeutic compounds such as: pentavalent antimonials (PA) denominated sodium stibogluconate (SSG) Pentostam® and meglumine antimoniate Glucantime® (MA), amphotericin B (AB), liposomal amphotericin B (L-AB), miltefosine (MIL) and paromomycin (PM), but generally present several drawbacks: a long period of intravenous administration (IV) or intramuscular (IM) injections, drug resistance has been detected in close relation to the high percentage of inefficient treatments, produce serious side effects in individuals and some have high costs, which makes inaccessible the treatments for people with low economic resources that constitute a large part of the population affected by VL. The SSG has been used during decades, but also present a high toxicity and problems with your effectiveness caused by the resistance of the parasites.

This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).