What is it about?
We studied visceral leishmaniasis, a serious disease caused by a parasite transmitted by insects, which can be fatal if left untreated. The situation becomes even more severe when individuals are also living with HIV, because their immune system is weakened. Our aim was to understand how cases of visceral leishmaniasis and HIV coinfection have changed over time and which characteristics are most commonly associated with this combination of diseases in an endemic region of Brazil. We analyzed all reported cases in the state of Mato Grosso do Sul between 2012 and 2022. We found that, although the overall number of visceral leishmaniasis cases remained relatively stable, the number of cases among people living with HIV increased in recent years, especially after 2018. We also identified that older men and individuals presenting symptoms such as weight loss and cough were more likely to have the coinfection. In contrast, classic signs of visceral leishmaniasis, including fever and enlargement of the liver or spleen, were less frequent in coinfected patients. These findings show that visceral leishmaniasis may present differently in people living with HIV, which can make diagnosis more difficult. Therefore, our results highlight the importance of increased attention to vulnerable groups and early diagnosis in order to improve care and reduce complications.
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Why is it important?
This study highlights the recent increase in visceral leishmaniasis and HIV coinfection in an endemic region of Brazil, even while overall leishmaniasis cases have remained stable. By integrating temporal trends with clinical data, we show that coinfection often presents with atypical symptoms, which may hinder timely diagnosis. By identifying vulnerable groups and non-classic clinical patterns, this work provides practical evidence to improve screening, early detection, and integration between visceral leishmaniasis and HIV surveillance programs. These findings have relevance beyond the local context, offering valuable insights for researchers, clinicians, and public health policymakers working on neglected diseases in settings of overlapping vulnerabilities.
Perspectives
This article was important to me because, by actively contributing to the writing and discussion of the results, I had the opportunity to become more familiar with the topic of visceral leishmaniasis and HIV coinfection and to engage closely with the other co-authors. This process deepened my understanding of the clinical and public health challenges involved and reinforced the importance of making these findings more visible and accessible. I hope this work helps raise awareness among professionals and researchers about the value of timely diagnosis and integrated care in endemic settings.
Kely Vilena
Universidade Catolica Dom Bosco
Read the Original
This page is a summary of: Temporal analysis and factors associated with visceral leishmaniasis-HIV-AIDS coinfection in an endemic region of Brazil, PLoS Neglected Tropical Diseases, December 2025, PLOS,
DOI: 10.1371/journal.pntd.0013845.
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