Visceral leishmaniasis-HIV co-infection an emerging global health issue
Visceral leishmaniasis-HIV (VL/HIV) co-infection is an emerging global health issue, prominent in Africa, and on the rise in South America and India. Visceral leishmaniasis (VL) is a disease that develops from the leishmaniasis parasite, which is transmitted via the bite of a sand fly. VL is the biggest global parasite killer after malaria, and is a major concern for people living with HIV (PLHIV) as a potentially life threatening co-infection. A rapid increase in the number of cases of VL/HIV has called for greater for research to understand the co-infection, and how to roll out of prevention and treatment programs.
The leishmaniasis parasite causes visceral leishmaniasis, also called “kala-azar”, and is often deadly when not treated. People infected with HIV and co-infected with VL become ill more quickly and are less sensitive to treatment, as both pathogens strengthen each others existence. Testing for and diagnosing VL is difficult in general, but even more so when people are co-infected with HIV, and especially in low resourced countries. The treatment of VL in HIV co-infected patients is complex as drugs are less effective, resulting in death rates as high as 25 percent. Of the people who survive, up to 60 percent develop VL again within one year. As patients are repeatedly treated for long periods, there is risk that the parasite will build up resistance against current used treatment.
To effectively tackle the problem, a broader and deeper understanding of all dimensions of VL and VL/HIV co-infection is required. More attention on VL is also needed on health agendas, as in many endemic countries, VL care is still highly dependent on international actors. It is possible to control the VL/HIV co-infection, however involvement of all relevant stakeholders is needed. To adopt a multi-disciplinary response, a new journal collection has been launched by PLOS Neglected Tropical Diseases. The collection hopes to foster greater collaboration to tackle the clinical, biomedical, social and public health issues relating to this burgeoning problem.