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. 2016 Nov 21;145(4):453–463. doi: 10.1017/S0031182016002031

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)