**6.5 Human immunodeficiency virus (HIV): Visceral leishmaniasis coinfection**

VL should be treated as an opportunistic infection if diagnosed in patients with HIV, warranting lifelong antiretroviral therapy regardless of CD4 count [27]. The core infected patients require longer treatment with higher doses since they are at a higher risk for disease relapse, poor outcome, and increased mortality. In addition, developing VL disease in HIV patients adversely affects their response to antiretroviral therapy [43]. Current WHO recommendation, so far, is LAMB for all regions. Some cases may require combination treatment including LAMB with mitefosine, pentavalent antimonials, and/or amphotericin B deoxycholate. Randomized control trials are ongoing in both Ethiopia and India comparing combination of LAMB and miltefosine with LAMB monotherapy [44, 45].
