help find a reference?

Dr Robert N Davidson [Infection and Tropical Medicine] r.n.davidson at ic.ac.uk
Fri Jul 4 08:54:57 BRT 1997


Can the leishmaniacs who know the older literature on treatment of VL help
me find a reference? 
It concerns the significance of finding a few residual parasites in the
splenic (or bone marrow) aspirate at the end of treatment (in HIV NEG patients).
I've always understood that a high proportion (maybe 50%?) of those who have
visible or culturable parasites at the end of treatment will relapse
clinically and parasitologically, versus a low proportion (maybe <5%) of
those who have no detectable parasites. ((This is when a drug with a short
half life like Sbv is used. If a drug with a depot effect is used, the
test-of-cure aspirate is often delayed until all the drug has had a chance
to act.))

I'm sure I've read a paper in which VL patients were treated with Sbv, and
then observed - their subsequent rate of relapse of VL was then analysed
with respect to the result of their end of treatment aspirate. 
Anybody know the details? Or have unpublished experience on this?

Rob
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Dr Robert N Davidson       email:  r.n.davidson at ic.ac.uk
Infection and Tropical Medicine, Imperial College School of Medicine
Northwick Park Hospital, Harrow, HA1  3UJ. 
TEL ++44 181 869 2830     FAX ++44 181 869 2836
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