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<!DOCTYPE html> <html > <head> <meta charset="utf-8"> <meta rel="search" type="application/opensearchdescription+xml" href="/open_search.xml" title="Academia.edu"> <meta content="width=device-width, initial-scale=1" name="viewport"> <meta name="google-site-verification" content="bKJMBZA7E43xhDOopFZkssMMkBRjvYERV-NaN4R6mrs"> <meta name="csrf-param" content="authenticity_token" /> <meta name="csrf-token" content="++c2rMiM/hTgaRJ1vqKPCeWVfSwP+MCKgU84RToqlE0MCaq7UtjDozCLB1G2ieVwTsC22+A0i6aNvi4YFmbT5g==" /> <meta name="citation_title" content="Relapse after Treatment with Miltefosine for Visceral Leishmaniasis Is Associated with Increased Infectivity of the Infecting Leishmania donovani Strain" /> <meta name="citation_publication_date" content="2013/01/01" /> <meta name="citation_journal_title" content="mBio" /> <meta name="citation_author" content="narayan bhattarai" /> <meta name="twitter:card" content="summary" /> <meta name="twitter:url" content="https://www.academia.edu/87640808/Relapse_after_Treatment_with_Miltefosine_for_Visceral_Leishmaniasis_Is_Associated_with_Increased_Infectivity_of_the_Infecting_Leishmania_donovani_Strain" /> <meta name="twitter:title" content="Relapse after Treatment with Miltefosine for Visceral Leishmaniasis Is Associated with Increased Infectivity of the Infecting Leishmania donovani Strain" /> <meta name="twitter:description" content="Leishmania donovani is an intracellular protozoan parasite that causes leishmaniasis, which can range from a self-healing cutaneous disease to a fatal visceral disease depending on the infecting species. 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Miltefosine is currently the latest and only" /> <title>(PDF) Relapse after Treatment with Miltefosine for Visceral Leishmaniasis Is Associated with Increased Infectivity of the Infecting Leishmania donovani Strain | narayan bhattarai - Academia.edu</title> <link rel="canonical" href="https://www.academia.edu/87640808/Relapse_after_Treatment_with_Miltefosine_for_Visceral_Leishmaniasis_Is_Associated_with_Increased_Infectivity_of_the_Infecting_Leishmania_donovani_Strain" /> <script async src="https://www.googletagmanager.com/gtag/js?id=G-5VKX33P2DS"></script> <script> window.dataLayer = window.dataLayer || []; function gtag(){dataLayer.push(arguments);} gtag('js', new Date()); gtag('config', 'G-5VKX33P2DS', { cookie_domain: 'academia.edu', send_page_view: false, }); gtag('event', 'page_view', { 'controller': "single_work", 'action': "show", 'controller_action': 'single_work#show', 'logged_in': 'false', 'edge': 'unknown', // Send nil if there is no A/B test bucket, in case some records get logged // with missing data - that way we can distinguish between the two cases. // ab_test_bucket should be of the form <ab_test_name>:<bucket> 'ab_test_bucket': null, }) </script> <script> var $controller_name = 'single_work'; var $action_name = "show"; var $rails_env = 'production'; var $app_rev = '92477ec68c09d28ae4730a4143c926f074776319'; var $domain = 'academia.edu'; var $app_host = "academia.edu"; var $asset_host = "academia-assets.com"; var $start_time = new Date().getTime(); var $recaptcha_key = "6LdxlRMTAAAAADnu_zyLhLg0YF9uACwz78shpjJB"; var $recaptcha_invisible_key = "6Lf3KHUUAAAAACggoMpmGJdQDtiyrjVlvGJ6BbAj"; var $disableClientRecordHit = false; </script> <script> window.require = { config: function() { return function() {} } } </script> <script> window.Aedu = window.Aedu || {}; window.Aedu.hit_data = null; window.Aedu.serverRenderTime = new Date(1732791475000); window.Aedu.timeDifference = new Date().getTime() - 1732791475000; </script> <script type="application/ld+json">{"@context":"https://schema.org","@type":"ScholarlyArticle","abstract":"Leishmania donovani is an intracellular protozoan parasite that causes leishmaniasis, which can range from a self-healing cutaneous disease to a fatal visceral disease depending on the infecting species. Miltefosine is currently the latest and only oral antileishmanial that came out of drug discovery pipelines in the past few decades, but recent reports indicate a significant decline in its efficacy against visceral leishmaniasis (also known as kala-azar) in the Indian subcontinent. This relapse rate of up to 20% within 12 months after treatment was shown not to be related to reinfection, drug quality, drug exposure, or drug-resistant parasites. We therefore aimed to assess other phenotypes of the parasite that may affect treatment outcome and found a significant association between the number of metacyclic parasites, parasite infectivity, and patient treatment outcome in the Indian subcontinent. Together with previous studies on resistance of L. donovani against pentavalent antimon...","author":[{"@context":"https://schema.org","@type":"Person","name":"narayan bhattarai"}],"contributor":[],"dateCreated":"2022-09-30","dateModified":null,"datePublished":"2013-01-01","headline":"Relapse after Treatment with Miltefosine for Visceral Leishmaniasis Is Associated with Increased Infectivity of the Infecting Leishmania donovani Strain","inLanguage":"en","keywords":["Microbiology","Immunology","Biology","Leishmania","Virulence","Leishmaniasis","Humans","Indian subcontinent","Drug Resistance","Visceral Leishmaniasis","Recurrence","Miltefosine","Mbio","Infectivity","phosphorylcholine"],"locationCreated":null,"publication":"mBio","publisher":{"@context":"https://schema.org","@type":"Organization","name":"American Society for Microbiology"},"image":null,"thumbnailUrl":null,"url":"https://www.academia.edu/87640808/Relapse_after_Treatment_with_Miltefosine_for_Visceral_Leishmaniasis_Is_Associated_with_Increased_Infectivity_of_the_Infecting_Leishmania_donovani_Strain","sourceOrganization":[{"@context":"https://schema.org","@type":"EducationalOrganization","name":null}]}</script><link rel="stylesheet" media="all" href="//a.academia-assets.com/assets/single_work_page/loswp-102fa537001ba4d8dcd921ad9bd56c474abc201906ea4843e7e7efe9dfbf561d.css" /><link rel="stylesheet" media="all" href="//a.academia-assets.com/assets/design_system/body-8d679e925718b5e8e4b18e9a4fab37f7eaa99e43386459376559080ac8f2856a.css" /><link rel="stylesheet" media="all" href="//a.academia-assets.com/assets/design_system/button-3cea6e0ad4715ed965c49bfb15dedfc632787b32ff6d8c3a474182b231146ab7.css" /><link rel="stylesheet" media="all" 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"https://www.academia.edu/login?post_login_redirect_url=https%3A%2F%2Fwww.academia.edu%2F87640808%2FRelapse_after_Treatment_with_Miltefosine_for_Visceral_Leishmaniasis_Is_Associated_with_Increased_Infectivity_of_the_Infecting_Leishmania_donovani_Strain%3Fshow_translation%3Dtrue"; window.loswp.previewableAttachments = [{"id":91794766,"identifier":"Attachment_91794766","shouldShowBulkDownload":false}]; window.loswp.shouldDetectTimezone = true; window.loswp.shouldShowBulkDownload = true; window.loswp.showSignupCaptcha = false window.loswp.willEdgeCache = false; window.loswp.work = {"work":{"id":87640808,"created_at":"2022-09-30T13:30:32.486-07:00","from_world_paper_id":216339265,"updated_at":"2022-09-30T13:53:44.752-07:00","_data":{"abstract":"Leishmania donovani is an intracellular protozoan parasite that causes leishmaniasis, which can range from a self-healing cutaneous disease to a fatal visceral disease depending on the infecting species. Miltefosine is currently the latest and only oral antileishmanial that came out of drug discovery pipelines in the past few decades, but recent reports indicate a significant decline in its efficacy against visceral leishmaniasis (also known as kala-azar) in the Indian subcontinent. This relapse rate of up to 20% within 12 months after treatment was shown not to be related to reinfection, drug quality, drug exposure, or drug-resistant parasites. We therefore aimed to assess other phenotypes of the parasite that may affect treatment outcome and found a significant association between the number of metacyclic parasites, parasite infectivity, and patient treatment outcome in the Indian subcontinent. Together with previous studies on resistance of L. donovani against pentavalent antimon...","publisher":"American Society for Microbiology","publication_date":"2013,,","publication_name":"mBio"},"document_type":"paper","pre_hit_view_count_baseline":null,"quality":"high","language":"en","title":"Relapse after Treatment with Miltefosine for Visceral Leishmaniasis Is Associated with Increased Infectivity of the Infecting Leishmania donovani Strain","broadcastable":false,"draft":null,"has_indexable_attachment":true,"indexable":true}}["work"]; window.loswp.workCoauthors = [71219665]; window.loswp.locale = "en"; window.loswp.countryCode = "SG"; window.loswp.cwvAbTestBucket = ""; window.loswp.designVariant = "ds_vanilla"; window.loswp.fullPageMobileSutdModalVariant = "full_page_mobile_sutd_modal"; window.loswp.useOptimizedScribd4genScript = false; window.loswp.appleClientId = 'edu.academia.applesignon';</script><script defer="" src="https://accounts.google.com/gsi/client"></script><div class="ds-loswp-container"><div class="ds-work-card--grid-container"><div class="ds-work-card--container js-loswp-work-card"><div class="ds-work-card--cover"><div class="ds-work-cover--wrapper"><div class="ds-work-cover--container"><button class="ds-work-cover--clickable js-swp-download-button" data-signup-modal="{"location":"swp-splash-paper-cover","attachmentId":91794766,"attachmentType":"pdf"}"><img alt="First page of “Relapse after Treatment with Miltefosine for Visceral Leishmaniasis Is Associated with Increased Infectivity of the Infecting Leishmania donovani Strain”" class="ds-work-cover--cover-thumbnail" src="https://0.academia-photos.com/attachment_thumbnails/91794766/mini_magick20220930-1-y1az55.png?1664569946" /><img alt="PDF Icon" class="ds-work-cover--file-icon" src="//a.academia-assets.com/assets/single_work_splash/adobe.icon-574afd46eb6b03a77a153a647fb47e30546f9215c0ee6a25df597a779717f9ef.svg" /><div class="ds-work-cover--hover-container"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">download</span><p>Download Free PDF</p></div><div class="ds-work-cover--ribbon-container">Download Free PDF</div><div class="ds-work-cover--ribbon-triangle"></div></button></div></div></div><div class="ds-work-card--work-information"><h1 class="ds-work-card--work-title">Relapse after Treatment with Miltefosine for Visceral Leishmaniasis Is Associated with Increased Infectivity of the Infecting Leishmania donovani Strain</h1><div class="ds-work-card--work-authors ds-work-card--detail"><a class="ds-work-card--author js-wsj-grid-card-author ds2-5-body-md ds2-5-body-link" data-author-id="71219665" href="https://independent.academia.edu/narayanbhattarai2"><img alt="Profile image of narayan bhattarai" class="ds-work-card--author-avatar" src="//a.academia-assets.com/images/s65_no_pic.png" />narayan bhattarai</a></div><div class="ds-work-card--detail"><p class="ds-work-card--detail ds2-5-body-sm">2013, mBio</p></div><p class="ds-work-card--work-abstract ds-work-card--detail ds2-5-body-md">Leishmania donovani is an intracellular protozoan parasite that causes leishmaniasis, which can range from a self-healing cutaneous disease to a fatal visceral disease depending on the infecting species. Miltefosine is currently the latest and only oral antileishmanial that came out of drug discovery pipelines in the past few decades, but recent reports indicate a significant decline in its efficacy against visceral leishmaniasis (also known as kala-azar) in the Indian subcontinent. This relapse rate of up to 20% within 12 months after treatment was shown not to be related to reinfection, drug quality, drug exposure, or drug-resistant parasites. We therefore aimed to assess other phenotypes of the parasite that may affect treatment outcome and found a significant association between the number of metacyclic parasites, parasite infectivity, and patient treatment outcome in the Indian subcontinent. Together with previous studies on resistance of L. donovani against pentavalent antimon...</p><div class="ds-work-card--button-container"><button class="ds2-5-button js-swp-download-button" data-signup-modal="{"location":"continue-reading-button--work-card","attachmentId":91794766,"attachmentType":"pdf","workUrl":"https://www.academia.edu/87640808/Relapse_after_Treatment_with_Miltefosine_for_Visceral_Leishmaniasis_Is_Associated_with_Increased_Infectivity_of_the_Infecting_Leishmania_donovani_Strain"}">See full PDF</button><button class="ds2-5-button ds2-5-button--secondary js-swp-download-button" data-signup-modal="{"location":"download-pdf-button--work-card","attachmentId":91794766,"attachmentType":"pdf","workUrl":"https://www.academia.edu/87640808/Relapse_after_Treatment_with_Miltefosine_for_Visceral_Leishmaniasis_Is_Associated_with_Increased_Infectivity_of_the_Infecting_Leishmania_donovani_Strain"}"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">download</span>Download PDF</button></div></div></div></div><div data-auto_select="false" data-client_id="331998490334-rsn3chp12mbkiqhl6e7lu2q0mlbu0f1b" data-doc_id="91794766" data-landing_url="https://www.academia.edu/87640808/Relapse_after_Treatment_with_Miltefosine_for_Visceral_Leishmaniasis_Is_Associated_with_Increased_Infectivity_of_the_Infecting_Leishmania_donovani_Strain" data-login_uri="https://www.academia.edu/registrations/google_one_tap" data-moment_callback="onGoogleOneTapEvent" id="g_id_onload"></div><div class="ds-top-related-works--grid-container"><div class="ds-related-content--container ds-top-related-works--container"><h2 class="ds-related-content--heading">Related papers</h2><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="0" data-entity-id="50743685" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/50743685/Phase_4_Trial_of_Miltefosine_for_the_Treatment_of_Indian_Visceral_Leishmaniasis">Phase 4 Trial of Miltefosine for the Treatment of Indian Visceral Leishmaniasis</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="106909609" href="https://independent.academia.edu/NaveenKumar2390">Naveen Kumar</a></div><p class="ds-related-work--metadata ds2-5-body-xs">The Journal of …, 2007</p><p class="ds-related-work--abstract ds2-5-body-sm">Visceral leishmaniasis (VL) is a major public health problem in Bihar, accounting for 90% of all cases in India. Development of high levels of resistance to various existing drugs necessitated the search for alternative orally administered drugs. Hospital-based studies have shown that oral miltefosine is a highly effective treatment for VL both in adults and in children. An open, single-arm trial was designed to investigate the feasibility of treatment of VL patients with miltefosine in field conditions in 13 centers in Bihar. The phase 4 study was conducted among 1132 adult and pediatric VL patients. Compliance was good, with 1084 (95.5%) patients completing the full 28-day treatment course. Nine hundred and seventy-one (85.8%) patients returned for the final cure assessment at 6 months after treatment. The final cure rate was 82% by intention to treat analysis and 95% by per protocol analysis (similar to the 94% cure rate in hospitalized patients). Treatment-related adverse events...</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Phase 4 Trial of Miltefosine for the Treatment of Indian Visceral Leishmaniasis","attachmentId":68615179,"attachmentType":"pdf","work_url":"https://www.academia.edu/50743685/Phase_4_Trial_of_Miltefosine_for_the_Treatment_of_Indian_Visceral_Leishmaniasis","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/50743685/Phase_4_Trial_of_Miltefosine_for_the_Treatment_of_Indian_Visceral_Leishmaniasis"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="1" data-entity-id="5576552" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/5576552/Efficacy_of_miltefosine_in_the_treatment_of_visceral_leishmaniasis_in_India_after_a_decade_of_use">Efficacy of miltefosine in the treatment of visceral leishmaniasis in India after a decade of use</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="7937963" href="https://curaj.academia.edu/VijayKumarPrajapati">Vijay Kumar Prajapati</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2012</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Efficacy of miltefosine in the treatment of visceral leishmaniasis in India after a decade of use","attachmentId":49233033,"attachmentType":"pdf","work_url":"https://www.academia.edu/5576552/Efficacy_of_miltefosine_in_the_treatment_of_visceral_leishmaniasis_in_India_after_a_decade_of_use","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/5576552/Efficacy_of_miltefosine_in_the_treatment_of_visceral_leishmaniasis_in_India_after_a_decade_of_use"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="2" data-entity-id="25709804" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/25709804/Failure_of_miltefosine_treatment_for_visceral_leishmaniasis_in_children_and_men_in_South_East_Asia">Failure of miltefosine treatment for visceral leishmaniasis in children and men in South-East Asia</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="49404864" href="https://independent.academia.edu/EpcoHasker">Epco Hasker</a></div><p class="ds-related-work--metadata ds2-5-body-xs">PloS one, 2014</p><p class="ds-related-work--abstract ds2-5-body-sm">High frequency of relapse in miltefosine-treated visceral leishmaniasis (VL) patients in India and Nepal followed up for twelve months. To identify epidemiological and clinical risk factors for relapse of VL in patients recently treated with standard dosing of miltefosine in India and Nepal. Prospective observational study in three Primary Health Centers and one reference center in Muzaffarpur district, Bihar, India; and two zonal hospitals and a university hospital in South-east Nepal; records of all consenting patients diagnosed with VL and treated with miltefosine according to the current treatment guidelines of the Kala azar elimination program between 2009 and 2011. We compared the clinical records of 78 cases of relapse with those of 775 patients who had no record of subsequent relapse. Relapse was 2 times more common amongst male patients (IRR 2.14, 95% CI 1.27-3.61), and 2 to 3 times more frequent in the age groups below 15 compared to the over 25 year olds (age 10 to 14: IR...</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Failure of miltefosine treatment for visceral leishmaniasis in children and men in South-East Asia","attachmentId":46056613,"attachmentType":"pdf","work_url":"https://www.academia.edu/25709804/Failure_of_miltefosine_treatment_for_visceral_leishmaniasis_in_children_and_men_in_South_East_Asia","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/25709804/Failure_of_miltefosine_treatment_for_visceral_leishmaniasis_in_children_and_men_in_South_East_Asia"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="3" data-entity-id="57957708" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/57957708/Pharmacovigilance_of_Miltefosine_in_Treatment_of_Visceral_Leishmaniasis_in_Endemic_Areas_of_Bihar_India">Pharmacovigilance of Miltefosine in Treatment of Visceral Leishmaniasis in Endemic Areas of Bihar, India</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="45290975" href="https://independent.academia.edu/NiyamatSiddiqui">Niyamat Siddiqui</a></div><p class="ds-related-work--metadata ds2-5-body-xs">The American journal of tropical medicine and hygiene, 2016</p><p class="ds-related-work--abstract ds2-5-body-sm">Miltefosine, the only oral drug for visceral leishmaniasis (VL), is being used as the first-line drug under the VL elimination program in the Indian subcontinent. Miltefosine is an oral drug which was used as a topical application for skin metastasis of breast cancer. It was found to be effective against Leishmania donovani The main adverse events (AE) reported previously with miltefosine use includes diarrhea, vomiting, and dehydration. Other AEs include, raised serum alanine transaminase/aspartate aminotransferase and renal parameters such as creatinine. In this study, we report AEs in a large patient cohort of VL treated with miltefosine. The purpose of this pharmacovigilance study was to assess adverse drug reactions (ADRs)/AE of miltefosine treatment under unrestricted condition in the field setup. Patients were followed up to 6 months for therapeutic effectiveness. Outcomes of a larger data set of patients treated with this regimen from April 2012 to March 2015 were recorded. ...</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Pharmacovigilance of Miltefosine in Treatment of Visceral Leishmaniasis in Endemic Areas of Bihar, India","attachmentId":72602905,"attachmentType":"pdf","work_url":"https://www.academia.edu/57957708/Pharmacovigilance_of_Miltefosine_in_Treatment_of_Visceral_Leishmaniasis_in_Endemic_Areas_of_Bihar_India","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/57957708/Pharmacovigilance_of_Miltefosine_in_Treatment_of_Visceral_Leishmaniasis_in_Endemic_Areas_of_Bihar_India"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="4" data-entity-id="31266809" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/31266809/Treatment_failure_in_leishmaniasis_drug_resistance_or_another_epi_phenotype">Treatment failure in leishmaniasis: drug-resistance or another (epi-) phenotype?</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="34953946" href="https://independent.academia.edu/JorgeGuevaraArevalo">Jorge Guevara Arevalo</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Expert Review of Anti-infective Therapy, 2014</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Treatment failure in leishmaniasis: drug-resistance or another (epi-) phenotype?","attachmentId":51670325,"attachmentType":"pdf","work_url":"https://www.academia.edu/31266809/Treatment_failure_in_leishmaniasis_drug_resistance_or_another_epi_phenotype","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/31266809/Treatment_failure_in_leishmaniasis_drug_resistance_or_another_epi_phenotype"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="5" data-entity-id="25330071" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/25330071/Inadequacy_of_12_Week_Miltefosine_Treatment_for_Indian_Post_Kala_Azar_Dermal_Leishmaniasis">Inadequacy of 12-Week Miltefosine Treatment for Indian Post-Kala-Azar Dermal Leishmaniasis</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="26841800" href="https://independent.academia.edu/MukhopadhyayD">Debanjan Mukhopadhyay</a></div><p class="ds-related-work--metadata ds2-5-body-xs">The American journal of tropical medicine and hygiene, 2015</p><p class="ds-related-work--abstract ds2-5-body-sm">Post-kala-azar dermal leishmaniasis (PKDL) is a chronic dermatosis that generally occurs after apparent cure of visceral leishmaniasis caused by Leishmania donovani. In view of the prolonged treatment regimens necessary for PKDL, noncompliance is a major limitation; an optimal regimen is yet to be defined, but 12 weeks of therapy with miltefosine is generally recommended. We performed a single-arm open-label trial of miltefosine administered daily for 16 weeks in 27 patients in Kolkata with PKDL. After 4 weeks of treatment, nine patients were lost to follow-up because of unacceptable side effects, including severe abdominal pain, nausea, and vomiting. Of the 18 remaining patients, seven completed 12 weeks of therapy and 11 completed 16 weeks of therapy. Three of the seven who received 12 weeks of therapy and none of the 11 who received 16 weeks of therapy experienced disease relapse. Our results suggest that a 16-week course of miltefosine is required for reliable cure of PKDL. Furt...</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Inadequacy of 12-Week Miltefosine Treatment for Indian Post-Kala-Azar Dermal Leishmaniasis","attachmentId":45628256,"attachmentType":"pdf","work_url":"https://www.academia.edu/25330071/Inadequacy_of_12_Week_Miltefosine_Treatment_for_Indian_Post_Kala_Azar_Dermal_Leishmaniasis","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/25330071/Inadequacy_of_12_Week_Miltefosine_Treatment_for_Indian_Post_Kala_Azar_Dermal_Leishmaniasis"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 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