Drug resistance and treatment failure in leishmaniasis: A 21st century challenge
Date
2017
Authors
Ponte-Sucre, Alicia
Gamarro, Francisco
Dujardin, Jean-Claude
Barrett, Michael P.
Lo pez-VeÂlez, Rogelio
GarcõÂa-HernaÂndez, Raquel
Pountain, Andrew W
Papadopoulou, Barbara
Mwenechanya, Roy
Journal Title
Journal ISSN
Volume Title
Publisher
PLOS Neglected Tropical Diseases
Abstract
Reevaluation of treatment guidelines for Old and New World leishmaniasis is urgently
needed on a global basis because treatment failure is an increasing problem. Drug resistance
is a fundamental determinant of treatment failure, although other factors also contribute
to this phenomenon, including the global HIV/AIDS epidemic with its accompanying
impact on the immune system. Pentavalent antimonials have been used successfully worldwide
for the treatment of leishmaniasis since the first half of the 20th century, but the last 10
to 20 years have witnessed an increase in clinical resistance, e.g., in North Bihar in India. In
this review, we discuss the meaning of ªresistanceº related to leishmaniasis and discuss its
molecular epidemiology, particularly for Leishmania donovani that causes visceral leishmaniasis.
We also discuss how resistance can affect drug combination therapies. Molecular
mechanisms known to contribute to resistance to antimonials, amphotericin B, and miltefosine
are also outlined.
Description
Journal article
Keywords
Chemotherapy , Leishmaniasts