A new hope for people with visceral leishmaniasis and HIV co-infection

WHO-recommended treatment combination improves outcomes for people affected by both diseases

14 Jun 2022

Viewpoint by
Dr Monique Wasunna, Eastern Africa Regional Director, DNDi
Dr Kavita Singh, India & South Asia Regional Director, DNDi

We are delighted to share the news that the World Health Organization (WHO) has released new guidelines for the treatment of visceral leishmaniasis (VL) in people living with HIV – recommending a new combination therapy proven significantly more effective than the previous standard treatment.

At DNDi we are proud to have mobilized our partnerships to contribute to the evidence evaluated by WHO in developing its new guidance. Our teams and research partners in Eastern Africa and South Asia have been focusing on studies to improve VL outcomes for people living with HIV for over a decade.

Both diseases affect the immune system, and both are fatal without treatment. When they occur together, treatment of both VL and HIV becomes more challenging – and their joint impact on the immune system can leave patients vulnerable to other life-threatening opportunistic infections such as tuberculosis and malaria.

In two Phase III clinical trials conducted in Northwest Ethiopia, led by DNDi, and in Bihar, India, led by Médecins Sans Frontières (MSF), participating patients were treated with liposomal amphotericin B (LAmB) alone, or a combination of LAmB with miltefosine. The combination treatment was shown to have an 88% efficacy rate in Ethiopia (compared to 55% for the standard treatment) and a 96% efficacy rate in India (compared to 88% for the standard treatment).

With concerted efforts by governments to update national treatment guidelines and scale up access to the new regimen, we know that we can make great strides: saving lives and reducing the terrible stigma and social exclusion that people facing both diseases so often experience.

We are grateful to our many partners and supporters who have accompanied DNDi in fulfilling our commitment to science and innovation for people living with VL and HIV, including MSF, the University of Gondar (Ethiopia), and the Rajendra Memorial Research Institute of Medical Sciences (India). Please join us as we continue our work to develop the simple, effective, all-oral treatments still needed to pave the road to sustainable VL elimination worldwide.