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Different immune alterations have been described in HIV‐infected patients with visceral leishmaniasis (VL). We aimed to identify the immunological factors involved in the lack of immunological recovery and VL relapses in HIV‐infected patients with VL, by comparison with other HIV‐infected patients.

We carried out a cross‐sectional study of 55 patients receiving suppressive combination antiretroviral therapy (cART) for at least 1 year: nine with previous relapsing VL, 20 with an immunodiscordant response (IDR) to cART (CD4 count < 200 cells/μL) and no previous VL, and 26 with a concordant response (CR) to cART (CD4 count > 350 cells/μL) without VL. Immunosenescence was investigated by analysing CD57⁺CD28⁻ levels, immune activation by analysing CD38⁺HLA‐DR⁺ levels, inflammation by analysing interleukin (IL)‐6 levels, and microbial translocation by analysing …