Leishmania–HIV coinfection had been reported from 35 endemic countries. Coinfection with HIV intensifies the burden of visceral and cutaneous leishmaniasis by causing severe forms that are more difficult to manage.
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Post-kala-azar dermal leishmaniasis (PKDL)
It occurs mainly in East Africa and on the Indian subcontinent, where up to 50% and 5-10% of patients with kala-azar, respectively, could develop the condition. It usually appears 6 months to 1 or more years after kala-azar has apparently been cured. But it can occur earlier. People with PKDL are considered to be a potential source of kala-azar infection.