VISCERAL LEISHMANIASIS (KALA-AZAR) IN 2 PATIENTS WITH HIV-1 INFECTION- ATYPICAL FEATURES AND RESPONSE TO THERAPY

Visceral leishmaniasis (VL) is a well recognized opportunistic infecti on in patients with HIV-1 infection, which may occasionally present wi th atypical features, We describe two patients with advanced HIV-1 inf ection (CD4<100/mm(3)) in whom visceral leishmaniasis presented with a typical features, and their response to therapy, Atypical features of visceral leishmaniasis in the two infected patients include absence of fever, dissemination to the duodenal mucosa and to the skin as xantho ma-like lesions. Therapy and secondary prophylaxis remain unsatisfacto ry, and studies to evaluate combinations of amphotericin B and immunot herapy are needed.