van Lunzen J, Kern P, Schmitz J, Brzoska J, Flessenkämper S, Dietrich M
Clinical Medicine Section, Bernhard-Nocht-Institute of Tropical Medicine, Hamburg, Germany.
Infection. 1993 Nov-Dec;21(6):362-6. doi: 10.1007/BF01728914.
Eight adult patients with visceral leishmaniasis acquired in mediterranean countries were treated in a prospective study with a combined immunomodulating and antiparasitic regimen consisting of low-dose interferon-gamma (IFN-gamma) and pentavalent antimony. The clinical outcome, hematological and parasitological parameters, the duration of treatment and number of treatment cycles as well as the cumulative dose of pentavalent antimony applied, have been evaluated. The combined treatment led to complete resolution of symptoms and parasitological cure in all cases of visceral leishmaniasis without major side effects. Combined treatment resulted in a significant reduction of duration of treatment (19 vs. 31 days, p < 0.02) and cumulative dose of pentavalent antimony (11.67 vs. 19.30 g, p < 0.02) compared to historical controls (n = 6). No relapses occurred after a median follow-up of 9 months (range: 2-28 months). We conclude that combination therapy is tolerated well and is highly effective in patients with visceral leishmaniasis. The addition of IFN-gamma to standard therapy with pentavalent antimony may reduce the cumulative dose of antimonial drugs, shortens the treatment period and probably reduces the number of relapses.
对8例在地中海国家感染内脏利什曼病的成年患者进行了一项前瞻性研究，采用低剂量干扰素-γ（IFN-γ）和五价锑组成的免疫调节与抗寄生虫联合方案进行治疗。评估了临床结局、血液学和寄生虫学参数、治疗持续时间和治疗周期数，以及所应用的五价锑的累积剂量。联合治疗使所有内脏利什曼病病例的症状完全缓解且寄生虫学治愈，无严重副作用。与历史对照（n = 6）相比，联合治疗显著缩短了治疗持续时间（19天对31天，p < 0.02）和五价锑的累积剂量（11.67 g对19.30 g，p < 0.02）。中位随访9个月（范围：2 - 28个月）后未发生复发。我们得出结论，联合疗法耐受性良好，对内脏利什曼病患者非常有效。在五价锑标准疗法中添加IFN-γ可能会减少锑剂药物的累积剂量，缩短治疗期，并可能减少复发次数。
