VISCERAL LEISHMANIASIS - NEW THERAPEUTIC TRENDS

Pentavalent antimonial compounds (Sb) remain the drugs of choice for i nitial therapy of visceral leishmaniasis (VL). Therapy of at least 20 days is recommended. Either pentamidine or amphotericin B can be used if stibio-resistance. Diabetes mellitus is the major complication of p entamidine therapy. Despite the fact that amphotericin B is usually hi ghly toxic when used intravenuously, its association with colloidal sy stems reduced this toxicity without any change in term of efficacity. This association might become the first choice therapy when minimal do ses will be established. Allopurinol which need to be systematically c ombined with Sb is not efficient in vivo. Numerous other compounds are currently investigated but none of them show enough efficiency to be used in humans. The synergy of gamma-interferon and other anti-leishma niasis compounds is of great interest, but the cost and avaibility of gamma-interferon limit its utilisation, especially in developing count ries. Despite the fact that evident progress have been made in the the rapy of VL, the search for an active compound, well tolerated, easy to prescribe and not expensive, is still needed.