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Article

Clinical, Laboratory, and Therapeutic Characteristics of Visceral Leishmaniasis with Emphasis on Immune Status: A Multicentre Cohort Study in Greece

by
Aristos Aristodimou
1,*,
Achilleas Gikas
1,
Maria Antoniou
2,
Karolina Akinosoglou
3,
Nikolaos Partalis
4,
Angelos Pefanis
5,
Periklis Panagopoulos
6,
Charalambos Christofidis
7 and
Evangelos I. Kritsotakis
8
1
Division of Internal Medicine, School of Medicine, University of Crete, 70013 Heraklion, Greece
2
Parasitology and Medical Entomology Unit, School of Medicine, University of Crete, 70013 Heraklion, Greece
3
Department of Internal Medicine, University General Hospital of Patras, 26504 Rio, Greece
4
First Department of Internal Medicine, General Hospital of Chania, 73100 Chania, Greece
5
Department of Medicine and 1st Department of Infectious Diseases, General Hospital for Thoracic Diseases “Sotiria”, 11527 Athens, Greece
6
Second Department of Internal Medicine, University General Hospital Alexandroupolis, Democritus University of Thrace, 68100 Alexandroupolis, Greece
7
Second Department of Internal Medicine, General Hospital of Volos, 38222 Volos, Greece
8
Laboratory of Biostatistics, School of Medicine, University of Crete, 70013 Heraklion, Greece
*
Author to whom correspondence should be addressed.
Pathogens 2026, 15(2), 141; https://doi.org/10.3390/pathogens15020141
Submission received: 6 January 2026 / Revised: 21 January 2026 / Accepted: 26 January 2026 / Published: 28 January 2026
(This article belongs to the Section Parasitic Pathogens)
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Abstract

Visceral leishmaniasis (VL) is an endemic zoonotic disease in southern Europe with increasing clinical relevance among immunocompromised populations; however, detailed clinical data remain scarce. This retrospective multicentre cohort study analysed patients with confirmed VL treated at seven hospitals in Greece over a 26-year period. Clinical, treatment, and outcome data were collected with a minimum follow-up of 18 months to assess cure, treatment failure, relapse, and mortality. A total of 144 patients were enrolled (59% male; mean age 41.8 years, range 0.1–84 years), most of whom were Greek nationals (85%) and resided in rural areas (61%). Fever was the primary reason for hospital admission in 95% of patients. At diagnosis, 42 patients (29%) were immunocompromised. These patients were significantly older than immunocompetent individuals and more likely to present with diarrhoea and arthralgia, whereas hepatomegaly was less frequent. Liposomal amphotericin B was administered to 90% of patients. Treatment failure occurred in 14 patients (10%) and was significantly associated with immunosuppression and leukaemia. Relapse within 18 months occurred in 5.5% of patients. Overall mortality was relatively low (7 patients, 5%), with one death directly attributable to VL. This study demonstrates that VL remains endemic in Greece, affects patients across all age groups, and is primarily autochthonous. Immunosuppression is associated with distinct clinical features and poorer treatment outcomes in VL, underscoring the need for heightened clinical vigilance, combined diagnostic approaches, and extended follow-up in vulnerable populations.
Keywords: visceral leishmaniasis; immunosuppression; Mediterranean region; Greece; Leishmania infantum; treatment outcome visceral leishmaniasis; immunosuppression; Mediterranean region; Greece; Leishmania infantum; treatment outcome

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MDPI and ACS Style

Aristodimou, A.; Gikas, A.; Antoniou, M.; Akinosoglou, K.; Partalis, N.; Pefanis, A.; Panagopoulos, P.; Christofidis, C.; Kritsotakis, E.I. Clinical, Laboratory, and Therapeutic Characteristics of Visceral Leishmaniasis with Emphasis on Immune Status: A Multicentre Cohort Study in Greece. Pathogens 2026, 15, 141. https://doi.org/10.3390/pathogens15020141

AMA Style

Aristodimou A, Gikas A, Antoniou M, Akinosoglou K, Partalis N, Pefanis A, Panagopoulos P, Christofidis C, Kritsotakis EI. Clinical, Laboratory, and Therapeutic Characteristics of Visceral Leishmaniasis with Emphasis on Immune Status: A Multicentre Cohort Study in Greece. Pathogens. 2026; 15(2):141. https://doi.org/10.3390/pathogens15020141

Chicago/Turabian Style

Aristodimou, Aristos, Achilleas Gikas, Maria Antoniou, Karolina Akinosoglou, Nikolaos Partalis, Angelos Pefanis, Periklis Panagopoulos, Charalambos Christofidis, and Evangelos I. Kritsotakis. 2026. "Clinical, Laboratory, and Therapeutic Characteristics of Visceral Leishmaniasis with Emphasis on Immune Status: A Multicentre Cohort Study in Greece" Pathogens 15, no. 2: 141. https://doi.org/10.3390/pathogens15020141

APA Style

Aristodimou, A., Gikas, A., Antoniou, M., Akinosoglou, K., Partalis, N., Pefanis, A., Panagopoulos, P., Christofidis, C., & Kritsotakis, E. I. (2026). Clinical, Laboratory, and Therapeutic Characteristics of Visceral Leishmaniasis with Emphasis on Immune Status: A Multicentre Cohort Study in Greece. Pathogens, 15(2), 141. https://doi.org/10.3390/pathogens15020141

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