CD4 and coinfection: HAART increases CD4+ count thus influencing the control of VL, but may not be enough in this complex scenario created by the co-infection HIV and Leishmania. Fernandéz-Cotarelo et al. [54] and others [41] have shown a decrease in the number of new episodes of VL in HIV-infected patients receiving HAART but also a tendency toward VL relapse.