In the last few years the number of human cases of American visceral leishmaniasis in the Metropoli

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Although cases of leishmaniasis co-infection have been described in acquired immunodeficiency

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Two former patients treated for the cutaneous form of American tegumentary leishmaniasis were reviewed eight and 11 years, respectively, following clinical cure. We were able to isolate Leishmania parasites in a culture of material from the two scar biopsies, and in one of them the parasite was characterized as Leishmania (Viannia) braziliensis. In both cases, the histopathology revealed discreet hyperceratosis and a slight infiltrate of mononuclear cells surrounding and on the walls of the surface and deep dermal vessels. No amastigotes were seen on immunohistochemical or histopathologic examination. The Montenegro skin test result and the in vitro lymphoproliferative response to Leishmania antigen were positive, but no specific IgG and IgM antibodies were detected. Otorhinolaryngologic examination showed no macroscopic alteration in the mucosae. These findings are important for the evaluation and criteria of post-treatment cure.

Triatoma brasiliensis is one of the most important vectors of Chagas disease in the semiarid Lent, 1941 and T. brasiliensis macromelasoma Galvão, 1956. These subspecies differ mainly in their cuticle colour pattern and were regarded as synonyms by Lent and Wygodzinsky (1979) Galvão, 1956. Their descriptions are based on the different chromatic patterns of pronotum, hemelytron and legs. A taxonomic key for the different subspecies can be found in Galvão (1956). These subspecies were synonymized by Lent and Wygodzinsky (1979), who simply asserted that "inter-grading forms are frequent". Whether T. brasiliensis consists of different melanic populations or the chromatic patterns observed are due to interspecific variation is unknown.In order to study this question, isoenzymatic, morphological and behavioural studies have been undertaken: morphological characters of the geni- tal structures show considerable individual heterogeneity, thus making the differentiation of the chromatic patterns with these structures impossible. However, observations on the homogeneity and stability of colour patterns of colonies reared in laboratory and the allopatry registered during field captures, indicate that T. brasiliensis presents distinct geographic populations (Costa et al. 1996c). Studies on the biology, feeding sources and natural infection of the different chromatic variants have been carried out (Costa et al. 1995a, b). The results using multilocus enzyme electrophoresis for comparing these distinct populations of T. brasiliensis are reported here. MATERIALS AND METHODSThe insects -One hundred and twenty specimens belonging to four chromatic populations of T. brasiliensis were tested: 30 F1 adults (15 females and 15 males) of each different chromatic patterns were used from colonies initiated with individuals collected from the field. The specimens captured were found in isolated colonies in different ecotopes. The localities where T. brasiliensis specimens were collected, the populations they represent and number of founder individuals are given in Table I. Voucher specimens are deposited in the Entomological Collection of Instituto Oswaldo Cruz-FIOCRUZ, Rio de Janeiro.

Cutaneous biopsies (n = 94) obtained from 88 patients with American tegumentary leishmaniasis were studied by conventional and immunohistochemical techniques. Specimens were distributed as active lesions of cutaneous leishmaniasis (n = 53) (Group I), cicatricial lesions of cutaneous leishmaniasis (n = 35) (Group II) and suggestive scars of healed mucosal leishmaniasis patients (n = 6) (Group III). In addition, active cutaneous lesions of other etiology (n = 24) (Group C1) and cutaneous scars not related to leishmaniasis (n = 10) (Group C2) were also included in the protocol. Amastigotes in

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