Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Treatments for HIV-visceral leishmaniasis co-infected patients

06.10.2014

Phase III clinical study in Ethiopia launched to test 2 treatments for HIV-visceral leishmaniasis co-infected patients

The international research & development (R&D) consortium, AfriCoLeish, formed by six research organizations from East Africa and Europe, has launched a Phase III clinical study to address the extreme difficulty in treating visceral leishmaniasis (VL) in patients who also are HIV-positive.


Migrant workers are one of the highly vulnerable, HIV-VL (visceral leishmaniasis) most-affected populations.

Credit: @ Don Paul-DNDi

The study will assess the efficacy and the safety of two treatments: a combination treatment of AmBisome® and miltefosine, and AmBisome® alone. This is the first randomized clinical trial in Africa to confirm the World Health Organization's recommendation for HIV-VL treatment. Two sites, Gondar and Abdurafi, in northwest Ethiopia, one of the highest burden areas in the world, have begun recruiting patients.

HIV-AIDS and VL, fatal without treatment, both affect the immune system of the patients. When the two diseases occur together, treatment of both diseases becomes more challenging. The risk of death from VL is nine times higher in patients who are co-infected with HIV. VL also accelerates the progression of HIV. Relapses of VL in patients co-infected with HIV are also very common, affecting half of treated patients within a year of initial treatment, and overall VL cure rates are significantly lower.

An emerging global problem, VL-HIV cases are reported in 35 countries worldwide, spanning Southern Europe, East Africa, the Indian subcontinent, and Latin America. One of the hardest hit areas in Africa is northwest Ethiopia, where anywhere from 20% to 40% of patients with VL were found to be also infected with HIV.

'Treating patients that suffer both HIV and visceral leishmaniasis is a real battle for clinicians. Research strongly suggests that we need to strike the right balance between stronger treatments and safer treatments', said Koert Ritmeijer, PhD, Health Advisor, Médecins Sans Frontières.

'Combining better initial cure treatments and preventing relapses will be a major step forward for our patients, who today fear that the diseases, which can be managed when they occur separately, often become a death sentence when they occur together. We have to do all we can to provide the most affected, a highly vulnerable migrant population, with an appropriate response', said Dr Ermias Diro, Principal Site Investigator, University of Gondar.

The Phase III clinical study conducted in Gondar and Abdurafi, Ethiopia, will assess the efficacy and safety of the combination of AmBisome® (30mg/kg total dose) and miltefosine (50mg or 100mg/day depending on the patient's weight), and AmBisome® alone (40mg/kg total dose). Total treatment duration is 28 days, if the tests show that the patient is parasite-negative (at day 29). Thereafter, the patient will start a secondary prophylaxis treatment aimed at preventing VL relapses and a one-year follow-up phase. A total of 132 patients will be recruited for the trial.

'Visceral leishmaniasis, notably in East Africa, is among the most neglected of all neglected tropical diseases. The work of this consortium to address the additional challenge of co-infection with HIV in Ethiopia is vital as it has begun to tackle one of the most challenging endemic areas and aspects of this fatal disease', said Dr Jorge Alvar, Head of Leishmanisis Programme, DNDi.

This clinical trial is conducted by DNDi (sponsor) in collaboration with MSF-Holland (co-sponsor); the University of Gondar (UoG), Ethiopia; the Institute of Tropical Medicine (ITM) Antwerp, Belgium; the London School of Hygiene & Tropical Medicine, UK; and is funded by the European Union (EU FP7); the Swiss Agency for Development and Cooperation (SDC), Switzerland; Médecins Sans Frontières; the Federal Ministry of Education and Research (BMBF) through KfW, Germany; the Medicor Foundation, Liechtenstein; and other private donors.

About the study:

  • Overall objective: identify a safe and effective treatment for VL in HIV co-infected patients 

     

  • Study design: a randomized, parallel arm, open-label clinical study

     

     

  • Treatment dosing schedule:
    • AmBisome® monotherapy: 40mg/kg total dose: intravenous infusion 5mg/kg on day 1-5, 10, 17, 24
    • AmBisome®: 30mg/kg total dose: intravenous infusion 5mg/kg on day 1, 3, 5, 7, 9, 11 and miltefosine: every day for 28 days, with 50mg/day (for patient weighting ≤ 25 kg) and 100 mg/day (for patient weighting > 25 kg)

     

     

  • Study duration:
    • Treatment duration is 28 days or 56 days in case of extended treatment (if tissue aspirate is parasite positive at day 29 and the patient is well). When the patients are tested parasite negative, they are eligible for a secondary prophylaxis – pentamidine 4mg/kg intramuscular injection or intravenous infusion once a month – and enter a one-year follow-up phase. At any stage as of day 29, if the patients are unwell, they receive a rescue therapy.

     

     

  • AmBisome® supply for the study is donated by Gilead. Pentamidine supply for the study is donated by Sanofi.

     

About visceral leishmaniasis (VL or kala-azar)

Visceral leishmaniasis is a neglected tropical disease caused by Leishmania donovani or L. infantum. There are an estimated 300,000 new cases of VL per annum. Fatal if left untreated, the disease approximately kills 40,000 people every year. 90% of cases occur in Sudan, Ethiopia, Kenya, Bangladesh, India, Nepal, and Brazil. VL is characterized by prolonged fever and splenomegaly. The current VL therapies administered include pentavalent antimonials [sodium stibogluconate (SSG) and meglumine antimoniate], AmBisome®, miltefosine, and paromomycin (PM).

About AfriCoLeish: http://www.africoleish.org

A research and development (R&D) international consortium, AfriCoLeish is supported by the European Union Seventh Framework Programme (EU FP7) through a grant of €3 million. The project aims to test new treatments for visceral leishmaniasis (VL or kala-azar) in East Africa and co-infection of the disease with HIV in Ethiopia. AfriCoLeish brings together six organizations from Europe and East Africa with vast experience in R&D and treatment of HIV and kala-azar, namely:

Press contact:

Renee Olende, Regional Communications Manager, DNDi Africa
Mobile: +254 705 639 909 / E-mail: rolende@dndi.org

Violaine Dällenbach | Eurek Alert!

Further reports about: HIV Medicine Tropical Medicine diseases intravenous parasite visceral leishmaniasis

More articles from Life Sciences:

nachricht Cancer diagnosis: no more needles?
25.05.2018 | Christian-Albrechts-Universität zu Kiel

nachricht Less is more? Gene switch for healthy aging found
25.05.2018 | Leibniz-Institut für Alternsforschung - Fritz-Lipmann-Institut e.V. (FLI)

All articles from Life Sciences >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Powerful IT security for the car of the future – research alliance develops new approaches

The more electronics steer, accelerate and brake cars, the more important it is to protect them against cyber-attacks. That is why 15 partners from industry and academia will work together over the next three years on new approaches to IT security in self-driving cars. The joint project goes by the name Security For Connected, Autonomous Cars (SecForCARs) and has funding of €7.2 million from the German Federal Ministry of Education and Research. Infineon is leading the project.

Vehicles already offer diverse communication interfaces and more and more automated functions, such as distance and lane-keeping assist systems. At the same...

Im Focus: Molecular switch will facilitate the development of pioneering electro-optical devices

A research team led by physicists at the Technical University of Munich (TUM) has developed molecular nanoswitches that can be toggled between two structurally different states using an applied voltage. They can serve as the basis for a pioneering class of devices that could replace silicon-based components with organic molecules.

The development of new electronic technologies drives the incessant reduction of functional component sizes. In the context of an international collaborative...

Im Focus: LZH showcases laser material processing of tomorrow at the LASYS 2018

At the LASYS 2018, from June 5th to 7th, the Laser Zentrum Hannover e.V. (LZH) will be showcasing processes for the laser material processing of tomorrow in hall 4 at stand 4E75. With blown bomb shells the LZH will present first results of a research project on civil security.

At this year's LASYS, the LZH will exhibit light-based processes such as cutting, welding, ablation and structuring as well as additive manufacturing for...

Im Focus: Self-illuminating pixels for a new display generation

There are videos on the internet that can make one marvel at technology. For example, a smartphone is casually bent around the arm or a thin-film display is rolled in all directions and with almost every diameter. From the user's point of view, this looks fantastic. From a professional point of view, however, the question arises: Is that already possible?

At Display Week 2018, scientists from the Fraunhofer Institute for Applied Polymer Research IAP will be demonstrating today’s technological possibilities and...

Im Focus: Explanation for puzzling quantum oscillations has been found

So-called quantum many-body scars allow quantum systems to stay out of equilibrium much longer, explaining experiment | Study published in Nature Physics

Recently, researchers from Harvard and MIT succeeded in trapping a record 53 atoms and individually controlling their quantum state, realizing what is called a...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

In focus: Climate adapted plants

25.05.2018 | Event News

Save the date: Forum European Neuroscience – 07-11 July 2018 in Berlin, Germany

02.05.2018 | Event News

Invitation to the upcoming "Current Topics in Bioinformatics: Big Data in Genomics and Medicine"

13.04.2018 | Event News

 
Latest News

In focus: Climate adapted plants

25.05.2018 | Event News

Flow probes from the 3D printer

25.05.2018 | Machine Engineering

Less is more? Gene switch for healthy aging found

25.05.2018 | Life Sciences

VideoLinks
Science & Research
Overview of more VideoLinks >>>