Screening for subclinical Leishmania infection in HIV-infected patients living in eastern Spain. (December 2014)

• Record Type: Journal Article
• Authors: Ena, Javier; Pasquau, Francisco; López-Perezagua, María del Mar; Martinez-Peinado, Carmen; Arjona, Francisco
• Is Part Of: Pathogens and global health. Volume 108:Number 8(2014)
• Page Start: 356
• Page End: 361
• Publication Date: 2014-12
• Subjects: Communicable diseases -- Periodicals; Public health -- International cooperation -- Periodicals; World health -- Periodicals; 362.1969
• DOI: 10.1179/2047773214Y.0000000164
• Languages: English
• ISSNs: 2047-7724

Abstract

<abstract> <title> <x content-type="archive" xml:space="preserve">Abstract</x> </title> <p>Background:We anticipated that patients with HIV infection living in endemic areas were at greater risk of infection which can reactivate due to immunosuppression; therefore, we analyzed the prevalence of latent <italic>Leishmania infantum</italic> infection in patients infected with HIV.</p> <p>Methods: A total of 179 patients with HIV infection were screened for the presence of anti-<italic>Leishmania</italic> antibodies using indirect immunofluorescent antibody test (IFAT) (<italic>Leishmania</italic>-spot IF; bioMérieux, Marcy l'Etoile, France). All patients were followed up for at least 1 year. The primary end-point was to confirm the presence of <italic>Leishmania</italic> infection.</p> <p>Results: Significant titer of antibodies to <italic>Leishmania</italic> was detected in six (3%; 95% confidence interval: 0·5–5·5%) asymptomatic patients. Two of them had visceral leishmaniasis that was confirmed by parasite visualization in clinical samples, the presence of <italic>Leishmania</italic> promastigotes in Novy–MacNeal–Nicolle culture, polymerase chain reaction (PCR)-based methods, and/or urinary antigen test. Among 173 patients with indirect immunofluorescent antibody test below 1∶40, one HIV-infected patient severely immunosuppressed, confirmed negative by IFAT, was diagnosed of visceral leishmaniasis.</p> <p>Conclusion: The use of indirect immunofluorescent antibody test for <italic>Leishmania</italic> screening is not justified in asymptomatic patients with HIV infection living in endemic areas due to the small rate of significant antibody titer and the low frequency of clinical disease.</p> </abstract>