Direct-acting antivirals and visceral leishmaniasis: a case report.

Authors:
Claudia Colomba
Claudia Colomba
Università di Palermo
Italy
Laura Saporito
Laura Saporito
Università di Palermo
Italy
Manlio Tolomeo
Manlio Tolomeo
Centro Interdipartimentale di Ricerca in Oncologia Clinica e Dipartimento Biomedico di Medicina Interna e Specialistica
Italy
Adriana Cervo
Adriana Cervo
University of Palermo
Alberto Firenze
Alberto Firenze
University of Palermo
Italy
Marcello Trizzino
Marcello Trizzino
Università di Palermo
Italy
Antonio Cascio
Antonio Cascio
University of Messina
Italy

BMC Infect Dis 2019 Apr 18;19(1):328. Epub 2019 Apr 18.

Dipartimento di Scienze per la promozione della Salute e Materno-infantile, Università di Palermo, Palermo, Italy.

Background: Visceral leishmaniasis is a vector-borne parasitic disease caused by protozoa belonging to the genus Leishmania. The clinical presentation of visceral leishmaniasis strictly depends on the host immunocompetency, whereas depressive conditions of the immune system impair the capability to resolve the infection and allow reactivation from sites of latency of the parasite.

Case Presentation: We describe a case of visceral leishmaniasis (VL) that occurred in a patient with chronic hepatitis C treated with direct-acting antiviral drugs (DAA). The hypothesized mechanism is the alteration of protective inflammation mechanisms secondary to DAA therapy. Downregulation of type II and III IFNs, their receptors, which accompany HCV clearance achieved during treatment with sofosbuvir and ribavirin might have a negative impact on a risk for reactivation of a previous Leishmania infection. We know indeed that IFN-γ is important to enhance killing mechanisms in macrophages, which are the primary target cells of Leishmania.

Conclusion: Since VL is endemic in Sicily as well as in other countries of the Mediterranean basin, physicians should be aware of the possible unmasking of cryptic Leishmania infection by DAAs.

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Source
https://bmcinfectdis.biomedcentral.com/articles/10.1186/s128
Publisher Site
http://dx.doi.org/10.1186/s12879-019-3947-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6471807PMC
April 2019
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References

(Supplied by CrossRef)
Article in Int J Infect Dis
L Saporito et al.
Int J Infect Dis 2013
Article in BMC Infect Dis
C Colomba et al.
BMC Infect Dis 2009
Article in J Chemother
P Pagliano et al.
J Chemother 2017
Article in Antivir Ther
M Puoti et al.
Antivir Ther 2004
Article in Antivir Ther
A Cascio et al.
Antivir Ther 2005
Article in Eur Rev Med Pharmacol Sci
C F et al.
Eur Rev Med Pharmacol Sci 2016
Article in Expert Opin Investig Drugs
N Shah et al.
Expert Opin Investig Drugs 2013
Article in Ann N Y Acad Sci
F Vitale et al.
Ann N Y Acad Sci 2004
Article in Gastroenterol Hepatol (N Y)
S Grandhe et al.
Gastroenterol Hepatol (N Y) 2017
Article in J Clin Invest
EG Meissner et al.
J Clin Invest 2014
Article in Lancet Gastroenterol Hepatol
M Mücke et al.
Lancet Gastroenterol Hepatol 2018

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