{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T17:38:13Z","timestamp":1757698693909,"version":"3.44.0"},"reference-count":7,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,11,29]]},"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:p>Visceral leishmaniasis (VL) is a protozoan infection caused by <jats:italic>Leishmania infantum<\/jats:italic> and <jats:italic>L. donovani<\/jats:italic> with a higher incidence and severity in HIV-infected patients due to its synergistic effect on hampering the immune response, often leading to death after treatment failure. Literature regarding the management of relapsing VL in HIV-coinfected patients is lacking. Many experts recommend a combined therapy with liposomal amphotericin B and miltefosine. The use of pentavalent antimonials is often discouraged due to their toxicity. We report two cases of successful response to treatment with combined therapy with meglumine antimoniate followed by secondary prophylaxis with miltefosine and atovaquone on relapsing VL in two HIV-coinfected patients despite treatment and monthly prophylaxis with appropriate doses of liposomal amphotericin B.<\/jats:p>","DOI":"10.1136\/bcr-2019-231929","type":"journal-article","created":{"date-parts":[[2019,12,17]],"date-time":"2019-12-17T04:45:16Z","timestamp":1576557916000},"page":"e231929","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Meglumine antimoniate combination treatment for relapsing Kala-azar after treatment and secondary prophylaxis failure with liposomal amphotericin B in two HIV-coinfected patients"],"prefix":"10.1136","volume":"12","author":[{"given":"Lara","family":"Camara","sequence":"first","affiliation":[{"name":"Servi\u00e7o de Medicina 2.3, Hospital Santo Ant\u00f3nio dos Capuchos, Lisboa, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jo\u00e3o","family":"Queir\u00f3s","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Medicina 2.3, Hospital Santo Ant\u00f3nio dos Capuchos, Lisboa, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rita","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Medicina 2.3, Hospital Santo Ant\u00f3nio dos Capuchos, Lisboa, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eug\u00e9nio","family":"Te\u00f3filo","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Medicina 2.3, Hospital Santo Ant\u00f3nio dos Capuchos, Lisboa, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,12,16]]},"reference":[{"key":"2025082803155774000_12.12.e231929.1","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1515\/jtim-2015-0002","article-title":"Leishmaniasis revisited: current aspects on epidemiology, diagnosis and treatment","volume":"3","author":"Georgiadou","year":"2015","journal-title":"J Transl Int Med"},{"key":"2025082803155774000_12.12.e231929.2","doi-asserted-by":"crossref","first-page":"443","DOI":"10.20344\/amp.8291","article-title":"[Visceral Leishmaniasis in HIV-Infected Patients: The Challenge of Relapse and Treatment Failure]","volume":"30","author":"Cipriano","year":"2017","journal-title":"Acta Med Port"},{"key":"2025082803155774000_12.12.e231929.3","first-page":"193","article-title":"Visceral leishmaniasis and HIV coinfection: current perspectives","volume":"10","author":"Lindoso","year":"2018","journal-title":"Hiv Aids"},{"key":"2025082803155774000_12.12.e231929.4","first-page":"32","article-title":"Treatment options for visceral leishmaniasis and HIV coinfection","volume":"18","author":"Monge-Maillo","year":"2016","journal-title":"AIDS Rev"},{"key":"2025082803155774000_12.12.e231929.5","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-199906180-00009"},{"key":"2025082803155774000_12.12.e231929.6","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0004304","article-title":"Antimony to cure visceral leishmaniasis unresponsive to liposomal amphotericin B","volume":"10","author":"Morizot","year":"2016","journal-title":"PLoS Negl Trop Dis"},{"key":"2025082803155774000_12.12.e231929.7","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.40.3.586"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2019-231929","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T10:16:06Z","timestamp":1756376166000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2019-231929"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,12]]},"references-count":7,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2019,12,16]]},"published-print":{"date-parts":[[2019,12]]}},"alternative-id":["10.1136\/bcr-2019-231929"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2019-231929","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2019,12]]}}}