Liposomal amphotericin B for the treatment of visceral leishmaniasis

Clin Infect Dis. 2006 Oct 1;43(7):917-24. doi: 10.1086/507530. Epub 2006 Aug 28.

Abstract

During the past decade, liposomal amphotericin B has been used with increasing frequency to treat visceral leishmaniasis (VL). The World Health Organization convened a workshop to review current knowledge and to develop guidelines for liposomal amphotericin B use for VL. In Europe, liposomal amphotericin B is widely used to treat VL. In Africa and Asia, the VL disease burden is high and drug access is poor; liposomal amphotericin B is available only through preferential pricing for nonprofit groups in East Africa. Clinical trials and experience demonstrate high efficacy and low toxicity for liposomal amphotericin B (total dose, 20 mg/kg) in immunocompetent patients with VL. Combination trials in areas with antileishmanial drug resistance, and treatment and secondary prophylaxis trials in VL-human immunodeficiency virus-coinfected patients, are important to safeguard the current armamentarium and to optimize regimens. The public health community should work to broaden access to preferential liposomal amphotericin B pricing by public sector VL treatment programs.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • AIDS-Related Opportunistic Infections / prevention & control
  • Amphotericin B / administration & dosage
  • Amphotericin B / economics
  • Amphotericin B / pharmacokinetics
  • Amphotericin B / therapeutic use*
  • Animals
  • Antiprotozoal Agents / administration & dosage
  • Antiprotozoal Agents / pharmacokinetics
  • Antiprotozoal Agents / therapeutic use*
  • Clinical Trials as Topic
  • Drug Carriers
  • Drug Costs
  • Health Planning Guidelines
  • Humans
  • Leishmaniasis, Visceral / drug therapy*
  • Liposomes
  • Treatment Outcome

Substances

  • Antiprotozoal Agents
  • Drug Carriers
  • Liposomes
  • liposomal amphotericin B
  • Amphotericin B