Table 3.
Overview of factors involved in VL disease progression and treatment failure
| Factor | References |
|---|---|
| Host | |
| Immunological factors | (Jarvis & Lockwood, 2013; Ostyn et al. 2014) |
| Pharmacokinetics | (Ostyn et al. 2014) |
| Genetics | (Blackwell, 1996; Castellucci et al. 2014) |
| Reinfection | (Rijal et al. 2013) |
| Environment | (Perry et al. 2013) |
| Drug | |
| Drug quality | (Dorlo et al. 2012a, b ) |
| Intrinsic drug properties (e.g. T1/2) | (Hastings et al. 2002) |
| Treatment duration | (Geli et al. 2012) |
| Non-compliance | (Rijal et al. 2013) |
| Parasite | |
| Lower intrinsic susceptibility to the drug | (Singh et al. 2006; Rijal et al. 2013) |
| – gene amplification of drug target enzymes | |
| – structural and functional modifications of drug target enzymes | (Mondelaers et al. 2016) |
| – decrease in intracellular drug concentration due to extrusion by specific transporters | |
| Higher parasite fitness | (Vanaerschot et al. 2014; Hendrickx et al. 2015b; Hendrickx et al. 2016) |