Treatment of Visceral Leishmaniasis in an Immunosuppressed Host Not Coinfected with HIV

Visceral leishmaniasis (VL) arising in a patient who is immunosuppressed but without HIV coinfection — including solid organ transplant recipients, individuals with lymphatic or hematologic malignancies, and patients receiving immunosuppressive therapy for other indications.

Immunosuppressed patients with VL who are not HIV-coinfected typically show higher response rates to initial treatment and lower recurrence rates than HIV-coinfected individuals, though the underlying immunosuppression demands careful management and close specialised follow-up.

When confirmed therapeutic failure occurs, retreatment with a lipid-based amphotericin formulation is a key approach — the complete evidence-based protocol, including all options and clinical decision points, is available in the full structured regimen.