01656nas a2200241   4500000000100000008004100001653003900042653001800081653002200099653003200121100001300153700001200166700001600178700001200194700001300206700001400219245006100233856009800294300001300392490000700405520098800412022001401400       2018                            d10aNeglected tropical diseases (NTDs)10aLeishmaniasis10aImmunosuppression10aVisceral leishmaniasis (VL)1 aAkuffo H1 aCosta C1 aGriensven J1 aBurza S1 aMoreno J1 aHerrero M00aNew insights into leishmaniasis in the immunosuppressed.  uhttp://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0006375&type=printable  ae00063750 v123 a<p>Immunosuppression contributes significantly to the caseload of visceral leishmaniasis (VL). HIV coinfection, solid organ transplantation, malnutrition, and helminth infections are the most important immunosuppression-related factors. This review briefly describes the challenges of these associations. East Africa and the Indian subcontinent are the places where HIV imposes the highest burden in VL. In the highlands of Northern Ethiopia, migrant rural workers are at a greater risk of coinfection and malnutrition, while in India, HIV reduces the sustainability of a successful elimination programme. As shown from a longitudinal cohort in Madrid, VL is an additional threat to solid organ transplantation. The association with malnutrition is more complex since it can be both a cause and a consequence of VL. Different regimes for therapy and secondary prevention are discussed as well as the role of nutrients on the prophylaxis of VL in poverty-stricken endemic areas.</p>
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