{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,8]],"date-time":"2026-02-08T00:14:33Z","timestamp":1770509673220,"version":"3.49.0"},"reference-count":14,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,2,7]]},"abstract":"<jats:p>The approach to treatment of visceral leishmaniasis (VL)-HIV co-infection in East Africa has not been systematically examined. Although antiretroviral treatment (ART) should be initiated for all co-infected persons, the extent of ART prescription is not known. We conducted a retrospective cohort study including all VL\u2013HIV co-infected adults at selected referral and district hospitals in northwest Ethiopia from 2010 to 2015. Purposes of the study were to compare the proportion of VL diagnoses made in previously diagnosed HIV-patients versus diagnosis concurrent with HIV diagnosis and to quantify utilization of ART. We included 112 patients and 58 patients at the referral and district hospital, respectively (median age: 30 years, 98% males). Of all VL cases, 56% (63\/112) and 19% (11\/58) occurred in known HIV patients at the referral and district hospital, respectively, with a median CD4 count at VL diagnosis of 45 cells\/\u00b5L and 248 cells\/\u00b5L at the referral and district hospital, respectively. Seventy-six percent (56\/44) were on ART at VL diagnosis and nine (12%) started ART after VL diagnosis. The remaining 96 (56%) patients had both infections diagnosed concurrently, with a median CD4 count of 56 and 143 cells\/\u00b5L at the referral and district hospital, respectively. Among cured patients, ART initiation was 67% and 36% at the referral and district hospital, respectively. A substantial proportion of VL\u2013HIV cases occur while in HIV care, requiring further evaluation of preventive strategies. Among newly diagnosed VL\u2013HIV co-infected patients, ART initiation was low. The reasons, including poor documentation and information exchange, should be assessed.<\/jats:p>","DOI":"10.4269\/ajtmh.17-0142","type":"journal-article","created":{"date-parts":[[2017,12,5]],"date-time":"2017-12-05T07:00:35Z","timestamp":1512457235000},"page":"486-491","source":"Crossref","is-referenced-by-count":7,"title":["Visceral Leishmaniasis and HIV Co-Infection in Northwest Ethiopia: Antiretroviral Treatment and Burden of Disease among Patients Enrolled in HIV Care"],"prefix":"10.4269","volume":"98","author":[{"given":"Johan","family":"van Griensven","sequence":"first","affiliation":[{"name":"Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tesfa","family":"Simegn","sequence":"additional","affiliation":[{"name":"Metema District Hospital, Ethiopia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mengistu","family":"Endris","sequence":"additional","affiliation":[{"name":"Department of Microbiology, University of Gondar, Gondar, Ethiopia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ermias","family":"Diro","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Gondar, Gondar, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Clin Microbiol Rev","first-page":"334","article-title":"The relationship between leishmaniasis and AIDS: the second 10 years","volume":"21","author":"Alvar","year":"2008"},{"key":"b2","series-title":"PLoS Negl Trop Dis","first-page":"e2869","article-title":"Visceral Leishmaniasis and HIV coinfection in East Africa","volume":"8","author":"Diro","year":"2014"},{"key":"b3","series-title":"Trop Med Int Health","first-page":"848","article-title":"Clinical characteristics and treatment outcome of patients with visceral leishmaniasis and HIV co-infection in northwest Ethiopia","volume":"15","author":"Hurissa","year":"2010"},{"key":"b4","series-title":"Clin Infect Dis","first-page":"e152","article-title":"Limited effectiveness of high-dose liposomal amphotericin B (AmBisome) for treatment of visceral leishmaniasis in an Ethiopian population with high HIV prevalence","volume":"53","author":"Ritmeijer","year":"2011"},{"key":"b5","series-title":"Clin Infect Dis","first-page":"1702","article-title":"Concordant HIV infection and visceral leishmaniasis in Ethiopia: the influence of antiretroviral treatment and other factors on outcome","volume":"46","author":"ter Horst","year":"2008"},{"key":"b6","series-title":"PLoS Negl Trop Dis","first-page":"e2916","article-title":"Visceral leishmaniasis as an AIDS defining condition: towards consistency across WHO guidelines","volume":"8","author":"van Griensven","year":"2014"},{"key":"b7","author":"WHO","year":"2010"},{"key":"b8","series-title":"Clin Microbiol Infect","first-page":"286","article-title":"Leishmaniasis in immunosuppressed individuals","volume":"20","author":"van Griensven","year":"2014"},{"key":"b9","series-title":"PLoS Negl Trop Dis","first-page":"e3011","article-title":"A screen and treat strategy targeting visceral leishmaniasis in HIV infected individuals in endemic east-African countries: the way forward?","volume":"8","author":"van Griensven","year":"2014"},{"key":"b10","author":"WHO","year":"2015"},{"key":"b11","author":"WHO","year":"2012"},{"key":"b12","series-title":"BMC Res Notes","first-page":"146","article-title":"Developing a point-of-care electronic medical record system for TB\/HIV co-infected patients: experiences from Lighthouse Trust, Lilongwe, Malawi","volume":"9","author":"Tweya","year":"2016"},{"key":"b13","series-title":"J Acquir Immune Defic Syndr","first-page":"S136","article-title":"PEPFAR support for the scaling up of collaborative TB\/HIV activities","volume":"60","author":"Howard","year":"2012"},{"key":"b14","series-title":"Lancet Infect Dis","first-page":"825","article-title":"Isoniazid prevention of HIV-associated tuberculosis","volume":"13","author":"Rangaka","year":"2013"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/98\/2\/article-p486.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/98\/2\/article-p486.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/98\/2\/article-p486.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,31]],"date-time":"2024-07-31T17:10:37Z","timestamp":1722445837000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/98\/2\/article-p486.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,2,7]]},"references-count":14,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.17-0142","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,2,7]]}}}