Asymptomatic carriers of Leishmania infantum in patients infected with human immunodeficiency virus (HIV) in Morocco

Echchakery, Mohamed; Nieto, Javier; Boussaa, Samia; Fajali, Noura; Ortega, Sergio; Souhail, K.; Aajly, H.; Chicharro, Carmen; Carrillo, Eugenia; Moreno, Javier; Boumezzough, Ali

doi:10.1007/s00436-018-5805-y

Cited by 23 publications

(19 citation statements)

References 41 publications

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“…Recently, in a systematic review of asymptomatic visceral leishmaniasis in the Indian subcontinent, Hirve et al [29], including 31 articles with different tests (rK39 immunochromatographic test, rK39 ELISA, DAT, PCR or Leishmanin skin test), found a prevalence from 0.25% to 36.9%, depending on the method used. Recently, Echchakery et al [18], in Morocco, found a prevalence of 5% in PLWH by indirect immuno uorescence. Clearly, there is no consensus about the best diagnostic tool to estimate the frequency of asymptomatic Leishmania infection in the population, and in the context of HIV infection, even in fully developed symptomatic disease, there are few data from Latin America regarding the performance of diagnostic methods [30].…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, it is important to evaluate the magnitude of this problem in other areas where asymptomatic immunosuppressed individuals can progress to symptomatic disease more frequently, with poor therapeutic outcomes and a high rate of relapse [13,[15][16][17]. Another important point is that PLWH could be asymptomatic carriers of Leishmania and only develop symptoms in the presence of severe immunosuppression, maintaining the transmission cycle of transmission in areas without other mammalian reservoirs [18,19].…”

Section: Introductionmentioning

confidence: 99%

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Frequency of Leishmania spp. infection among HIV-infected patients living in an urban area in Brazil: a cross-sectional study

Cunha

CELESTE

KESPER

et al. 2020

Preprint

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Background: There is little information about the frequency of Leishmania infection in asymptomatic people living with HIV (PLWH) and about the performance of laboratory diagnostic methods in coinfected patients in Latin America. The main objective of this study is to evaluate the frequency of Leishmania spp. infection in HIV-infected patients living in an urban area in Brazil. Methods: To detect Leishmania infection, diagnostic tests were performed to detect anti-Leishmania antibodies (ELISA using Leptomonas seymouri antigens; ELISA using rK39 antigens; ELISA using rK28 antigens; indirect fluorescent-antibody test (IFAT); direct agglutination test (DAT)) and Leishmania DNA (polymerase chain reaction (PCR) with the target genes kDNA and ITS-1). Results: The frequency of at least one positive test was 15%. For ELISA using Leptomonas antigens and IFAT, there was an association between CD4+ T lymphocyte counts and test positivity, with a higher positivity of these tests in more immunosuppressed patients (CD4+ T cell count < 200/mm3). Conclusions: According to our data, there was a high prevalence of Leishmania spp. infections in this population living with HIV. Although there is the possibility of cross-reaction, some tests that are considered highly specific for the diagnosis of Leishmania infection were positive. There was also an association between the positivity of some tests studied and lower values of CD4+ T lymphocytes.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Frequency of Leishmania spp. infection among HIV-infected patients living in an urban area in Brazil: a cross-sectional study

Cunha

CELESTE

KESPER

et al. 2020

Preprint

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“…What is more, we must keep in mind that 17% of the leishmaniasis cases in the Fuenlabrada outbreak involved some degree of immunosuppression [26] and that two of the three immunosuppressed patients studied in the present work were infective for sand flies. In Morocco, L. infantum has been detected in the 3% of HIV-coinfected asymptomatic patients by direct microscopic examination of smears of buffy-coat cells stained with May-Grünwald Giemsa [27] and in Italy, L. infantum DNA is present in 16.5% of HIV-infected asymptomatic patients [28]. On the other hand, it is necessary to draw attention to the fact that these patients are not systemically ill and may remain untreated for long periods, in the meantime being potentially infectious to sand flies [29].…”

Section: Discussionmentioning

confidence: 99%

Role of asymptomatic and symptomatic humans as reservoirs of visceral leishmaniasis in a Mediterranean context

Molina¹,

Jiménez²,

García‐Martínez³

et al. 2020

PLoS Negl Trop Dis

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Background In the Mediterranean basin, Leishmania infantum is the causative agent of visceral leishmaniasis (VL), a zoonosis in which the dog is the primary domestic reservoir, although wildlife may have a leading role in the sylvatic cycle of the disease in some areas. Infections without disease are very frequent. There is limited information regarding the role that VL patients and asymptomatic infected individuals could be playing in the transmission of L. infantum. Xenodiagnosis of leishmaniasis has been used in this descriptive study to explore the role of symptomatic and asymptomatic infected individuals as reservoirs in a recent focus of leishmaniasis in southwestern Madrid, Spain. Methodology and main findings Asymptomatic blood donors (n = 24), immunocompetent patients who were untreated (n = 12) or treated (n = 11) for visceral leishmaniasis (VL), and immunocompromised patients with VL (n = 3) were enrolled in the study. Their infectivity to Phlebotomus perniciosus was studied by indirect xenodiagnosis on peripheral blood samples. Quantitative polymerase chain reaction of blood samples from immunocompetent patients untreated for VL and immunocompromised untreated, treated and under secondary prophylaxis for VL was performed. Antibodies against Leishmania were studied by indirect fluorescent antibody and rK39-immunochromatographic tests. A lymphoproliferative assay with a soluble Leishmania antigen was used to screen for leishmaniasis infection in the healthy population. Sixty-two xenodiagnostic tests were carried out and 5,080 sand flies were dissected. Positive xenodiagnosis was recorded in four patients, with different sand fly infection rates: 1 immunosuppressed HIV / L. infantum coinfected asymptomatic patient, 1 immunosuppressed patient PLOS NEGLECTED TROPICAL DISEASES

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“…Latent infection of VL in HIV-infected patients has been noticed, so people living with HIV have a high risk of VL progression when Leishmania -infected. 8 This point could be better explored, because if patients present a decrease in CD4 + cell counts <200 cells/mm 3 , clinical manifestation of VL is more common. 9 …”

Section: Introductionmentioning

confidence: 99%

Visceral leishmaniasis and HIV coinfection: current perspectives

Lindoso¹,

Moreira²,

Cunha³

et al. 2018

HIV

108

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Visceral leishmaniasis (VL) is caused by Leishmania donovani and Leishmania infantum. The burden of VL is concentrated in tropical and subtropical areas; however, HIV infection has spread VL over a hyperendemic area. Several outcomes are observed as a result of VL–HIV coinfection. Impacts are observed in immunopathogenesis, clinical manifestation, diagnosis, and therapeutic response. Concerning clinical manifestation, typical and unusual manifestation has been observed during active VL in HIV-infected patient, as well as alteration in immunoresponse, inducing greater immunosuppression by low CD4 T-lymphocyte count or even by induction of immunoactivation, with cell senescence. Serological diagnosis of VL in the HIV-infected is poor, due to low humoral response, characterized by antibody production, so parasitological methods are more recommended. Another important and even more challenging point is the definition of the best therapeutic regimen for VL in HIV-coinfected patients, because in this population there is greater failure and consequently higher mortality. The challenge of better understanding immunopathogenesis in order to obtain more effective therapies is one of the crucial points to be developed. The combination of drugs and the use of secondary prophylaxis associated with highly active antiretroviral therapy may be the best tool for treatment of HIV coinfection. Some derivatives from natural sources have action against Leishmania; however, studies have been limited to in vitro evaluation, without clinical trials.

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Asymptomatic carriers of Leishmania infantum in patients infected with human immunodeficiency virus (HIV) in Morocco

Cited by 23 publications

References 41 publications

Frequency of Leishmania spp. infection among HIV-infected patients living in an urban area in Brazil: a cross-sectional study

Frequency of Leishmania spp. infection among HIV-infected patients living in an urban area in Brazil: a cross-sectional study

Role of asymptomatic and symptomatic humans as reservoirs of visceral leishmaniasis in a Mediterranean context

Visceral leishmaniasis and HIV coinfection: current perspectives

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