Patients

This study analyzes the effect of highly active antiretroviral therapy (HAART) on visceral leishmaniasis in human im-munodeficiency virus–infected individuals. We describe 66 episodes diagnosed in our hospital from 1994 through 2000 (35 episodes in patients who were not receiving HAART and 31 episodes in patients who were receiving HAART). Since HAART became available, the incidence of visceral leish-maniasis has significantly decreased and the number of first episodes has decreased, although the number of relapses is increasing. The advanced stage of HIV infection is characterized by the presence of numerous diseases and opportunistic infections. Among these is visceral leishmaniasis (VL), which is endemic in the Mediterranean basin, where 2%–9 % of all HIV-infected patients will experience an episode [1]. Although VL appears in patients with advanced stages of immunosuppression, it is not considered to be a diagnostic criterion for AIDS. The clin-ical development of HIV-Leishmania coinfection differs from that of VL in HIV-uninfected individuals: there is a high in-cidence of subclinical disease; limited sensitivity of diagnostic methods, such as serologic techniques; and a high rate of relapse in spite of treatment among HIV-Leishmania–coinfected pa-tients [2, 3]. Furthermore, pathogenic interactions between th