Multiple relapses of visceral leishmaniasis in a patient with HIV in India: a treatment challenge

Visceral leishmaniasis (VL) is an opportunistic infection of HIV-infected people in several endemic countries, and the management of this co-infection poses numerous challenges. We describe a patient with HIV infection and visceral leishmaniasis who failed to respond to miltefosine monotherapy and subsequently relapsed following two further different regimens of liposomal amphotericin B. He was then successfully treated with a combination of 30 mg/kg liposomal amphotericin B and 14 days of 100 mg/day oral miltefosine.