Follow-Up of Visceral Leishmaniasis Patients Treated with Meglumine Antimoniate

Abstract. Forty-two patients with visceral leishmaniasis in Tunisia were treated with meglumine antimoniate and followed-up for clinical improvement and blood parasite load determined by quantitative real-time polymerase chain reaction (PCR). Parasite loads before treatment ranged from 27 to 5.3 × 10 7 parasites/mL. At the end of treatment, parasite load decreased significantly in 39 cured patients ( P < 0.001). The decrease in parasite load after treatment was greater than 99 % for 34 patients and PCR results became negative in 23 of them. Two patients without clinical improve-ment showed no or slight decreases in parasite load (209 versus 202 parasites/mL and 1,765 versus 146 parasites/mL). One patient showed had a relapse seven months after showing a good response to treatment. His parasitemia remained high despite a sharp decrease (5.2 × 10 5 versus 5.9 × 10 3 parasites/mL)