Treatment failure in leishmaniasis: drug-resistance or another (epi-) phenotype?

Authors:
Manu Vanaerschot
Manu Vanaerschot
Institute of Tropical Medicine
Belgium
Franck Dumetz
Franck Dumetz
Institute of Tropical Medicine
Syamal Roy
Syamal Roy
Indian Institute of Chemical Biology
Kolkata | India
Alicia Ponte-Sucre
Alicia Ponte-Sucre
University of W├╝rzburg
Germany
Jorge Arevalo
Jorge Arevalo
Laboratorios de Investigaci├│n y Desarrollo
Peru

Expert Rev Anti Infect Ther 2014 Aug 6;12(8):937-46. Epub 2014 May 6.

Molecular Parasitology Unit, Department of Biomedical Sciences, Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerpen, Belgium.

Two major leishmaniasis treatments have shown a significant decrease in effectiveness in the last few decades, mostly in the Indian subcontinent but also in other endemic areas. Drug resistance of Leishmania correlated only partially to treatment failure (TF) of pentavalent antimonials, and has so far proved not to be important for the increased miltefosine relapse rates observed in the Indian subcontinent. While other patient- or drug-related factors could also have played a role, recent studies identified several parasite features such as infectivity and host manipulation skills that might contribute to TF. This perspective aims to discuss how different parasitic features other than drug resistance can contribute to TF of leishmaniasis and how this may vary between different epidemiological contexts.

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http://www.tandfonline.com/doi/full/10.1586/14787210.2014.91
Publisher Site
http://dx.doi.org/10.1586/14787210.2014.916614DOI Listing

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August 2014
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