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J Med Microbiol 55 (2006), 919-922; DOI: 10.1099/jmm.0.46574-0
© 2006 Society for General Microbiology
ISSN 1473-5644

Visceral leishmaniasis/human immunodeficiency virus co-infection in India: the focus of two epidemics

Purva Mathur, J. C. Samantaray, Madhu Vajpayee and Palash Samanta

Division of Parasitology and HIV/Immunology, Department of Microbiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi – 110029, India

Correspondence
J. C. Samantaray
jsamantaray{at}yahoo.com
and jsamantaray{at}hotmail.com

Received 10 February 2006
Accepted 23 March 2006

India contributes heavily to the global burden of visceral leishmaniasis (VL, kala-azar) and human immunodeficiency virus (HIV)/AIDS. The prevalence of HIV seropositivity in VL patients at a tertiary care centre in northern India, as observed during a prospective study over a period of 2 years, is presented. Of the 104 cases of VL/post-kala-azar dermal leishmaniasis, six (5.7 %) were found to be HIV positive, compared to 11 (5.5 %) seropositive for HIV of 198 patients with fever due to other causes. Four of the six (67 %) VL/HIV co-infected patients had a chronic/relapsing course, not responding to antileishmanial treatment. A CD4 T-cell count of <200 mm–3 was found in four of the five (80 %) co-infected patients in whom the test was done. Although the level of HIV/VL co-infection in the present study was lower than that of Mediterranean countries, there is a trend towards rising co-infection. The VL-endemic states of India have a huge population of migrant labourers, who work in high-HIV-prevalence states. The reported increase in the prevalence of HIV in the VL-endemic, populous states of India is a cause of grave concern, and co-infection may assume epidemic proportions in the coming decade if left unchecked.

Abbreviations: A/G ratio, albumin/globulin ratio; AIIMS, All India Institute of Medical Sciences; BM, bone marrow; HIV, human immunodeficiency virus; LD body, Leishman–Donovan body; PKDL, post-kala-azar dermal leishmaniasis; VL, visceral leishmaniasis.

A map of the distribution of HIV and VL in India is available with the online version of this paper.




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