内脏利什曼病（VL）是一种慢性传染病，在包括地中海盆地在内的热带和亚热带地区流行，由利什曼原虫属的一组原生动物寄生虫引起，并由静脉沙蝇传播。通常,当婴儿利什曼原虫是病原体时，VL被归类为人畜共患感染，当多诺瓦尼L.是病原体时，VL被归类为人畜共患感染。免疫功能低下的患者，特别是HIV阳性，被认为有VL的风险。由于T辅助细胞和调节细胞活性的减少，它们可能表现出非典型体征和对治疗的反应差。怀孕也可以被认为是利什曼原虫再激活和免疫反应变化的一种易感因素。由于在这种生活条件下报告的向Th2反应的转变。实验室诊断基于显微镜对骨髓或脾抽吸物的寄生虫检测。就敏感性而言，血清学的价值仍然很高，但是阳性测试必须通过显微镜或分子测试来确认。高球蛋白血症和全血细胞减少是通过血液检查确定的主要改变。治疗基于使用脂质体两性霉素B（L-AmB），其给药可降低副作用的发生率。关于AmB的抗辩剂和其他制剂。当婴儿乳杆菌是病原体时，米替福辛的使用需要进一步研究。在合并感染的HIV患者中观察到治疗的复发。他们可以受益于第二个周期，但治疗的累积疗效可能较低。
Visceral Leishmaniasis (VL) is a chronic infectious disease endemic in tropical and sub-tropical areas including the Mediterranean basin, caused by a group of protozoan parasites of the genus Leishmania and transmitted by phlebotomine sandflies. Typically, VL is classified as a zoonotic infection when Leishmania infantum is the causative agent and as an anthroponotic one when L. donovani is the causative agent. Immunocompromised patients, in particular HIV positive, are considered at risk of VL. They may present atypical signs and poor response to the treatment due to a compromission of T-helper and regulatory cells activity. Also pregnancy can be considered a condition predisposing to Leishmania reactivation and to the changes in immune response, due to a switch toward a Th2 response reported in this condition of the life. Laboratory diagnosis is based on microscopy for parasites detection on bone-marrow or spleen aspirates. Value of serology remains high in term of sensibility, but a positive test has to be confirmed by microscopy or molecular tests. Hypergammaglobulinemia and pancytopenia are the main alteration identified by blood examination. Treatment is based on use of liposomal amphotericin B (L-AmB) whose administration is associated to lower incidence of side effects, in respect to antimonials and other formulations of AmB. Use of Miltefosine needs further investigation when L. infantum is the causative agent. Relapses to treatment are observed in coinfected HIV patients. They can benefit of a second cycle, but cumulative efficacy of the treatment can be low.
