Diagnosis of visceral leishmaniasis in HIV-infected individuals using peripheral blood smears

Martínez, Pilar; E, de la Vega; Laguna, Fernando Ballester; Soriano, Vincent; Puente, Sabino; Moreno,; Mj, Sentchordi; García-Aguado, C; González-Lahoz, Juan

doi:10.1097/00002030-199302000-00011

Cited by 66 publications

(28 citation statements)

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“…Peripheral blood microscopy was positive in three of four cases. Further investigation is necessary to evaluate whether this high sensitivity occurs in transplanted patient as described in HIV [4,25,26]. Microscopy combined with PCR and culture diagnosed VL in up to 89% of cases.…”

Section: Discussionmentioning

confidence: 99%

Risk factors, clinical features and outcomes of visceral leishmaniasis in solid-organ transplant recipients: a retrospective multicenter case–control study

Clemente

Vidal

Girão

et al. 2015

Clinical Microbiology and Infection

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Visceral leishmaniasis (VL) is a rare disease in solid-organ transplant (SOT) recipients. Therefore, little is known about the risk factors and disease behavior in the transplant setting. This multicenter, matched case-control study (1:2 ratio) was designed to determine the risk factors, clinical features and outcomes of VL among this population. Control and case subjects were matched by center, transplant type and timing. Thirty-six VL cases were identified among 25 139 SOT recipients (0.1%). VL occurred 5.7-fold more frequently in Brazil than in Spain, presenting a median time of 11 months after transplantation. High-dose prednisone in the preceding 6 months was associated with VL. Patients were diagnosed over 1 month after symptom onset in 25% of cases. Thirty-one patients (86%) were febrile upon diagnosis, 81% exhibited visceromegaly and 47% showed pancytopenia. Concomitant infection was common. Parasites were identified in 89% of patients; the remaining patients were diagnosed by serology. The majority of the patients received amphotericin B. Relapses occurred in 25.7% of cases, and the crude mortality rate was 2.8%. VL after SOT is related to the VL prevalence in the general population. Delayed diagnosis frequently occurs. Liposomal amphotericin is the most commonly used therapy; mortality is low, although relapses are common. Clinical Microbiology and Infection

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Section: Discussionmentioning

confidence: 99%

Risk factors, clinical features and outcomes of visceral leishmaniasis in solid-organ transplant recipients: a retrospective multicenter case–control study

Clemente

Vidal

Girão

et al. 2015

Clinical Microbiology and Infection

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“…The idea for diagnosis of VL using peripheral blood buffy coat smears originated from studies in the early 1990s (12,14,15). These studies showed that the Leishmania parasite could be demonstrated by microscopy of peripheral blood smears of HIVinfected patients with visceral leishmaniasis.…”

Section: Discussionmentioning

confidence: 99%

Peripheral Blood Buffy Coat Smear: a Promising Tool for Diagnosis of Visceral Leishmaniasis

et al. 2012

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Confirmative diagnosis of visceral leishmaniasis (VL) is still a challenge at the primary health care facilities in most of the rural areas of endemicity in the Indian subcontinent. Conventional methods for parasitological confirmation are risky and require skilled personnel, and hence they are unavailable to the poor people in the regions of endemicity. Buffy coat smear microscopy, as a minimally invasive, simple alternative for the parasitological diagnosis of VL, was evaluated in this prospective study. One hundred twelve VL patients were enrolled in this study. The buffy coat was separated from peripheral blood of all enrolled subjects using Histopaque-1119 solution. Leishman-stained buffy coat smears were examined for Leishmania donovani bodies, and buffy coat was also utilized for detection of parasite DNA by Leishmania nested PCR (LnPCR) for all cases. Concomitant splenic smears could be examined for L. donovani bodies in 66 cases, and the parasite load was graded on a scale of 1؉ to 6؉ for L. donovani-positive smears. All splenic smear-positive cases were also found to be positive by LnPCR. Of 112 enrolled VL cases, 103 (92%) were found to be positive for L. donovani bodies in buffy coat smear microscopy, which is promising as a confirmative diagnosis tool. We have also found a significant association of the buffy coat smear positivity with parasitic burden in the spleen smear. In this preliminary observation in Bangladesh, buffy coat smear microscopy has been found to be very simple, minimally invasive, and risk-free method of parasitological diagnosis of VL with a good diagnostic accuracy and potential for field use.

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“…Bone marrow aspirate microscopy has been the most frequently employed diagnostic technique for VL-HIV cases, with reported sensitivities of 67 to 94% (7,82,160,189). Observation of amastigotes in peripheral blood-stained smears is a noninvasive method that yields a positivity rate of 50 to 53% for coinfected patients (146,153). Splenic aspiration is considered the most sensitive method for the diagnosis of VL, but the risk of hemorrhages cannot be discounted (approximately 0.1%).…”

Section: Parasitological Diagnosismentioning

confidence: 99%

The Relationship between Leishmaniasis and AIDS: the Second 10 Years

et al. 2008

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SUMMARY To date, most Leishmania and human immunodeficiency virus (HIV) coinfection cases reported to WHO come from Southern Europe. Up to the year 2001, nearly 2,000 cases of coinfection were identified, of which 90% were from Spain, Italy, France, and Portugal. However, these figures are misleading because they do not account for the large proportion of cases in many African and Asian countries that are missed due to a lack of diagnostic facilities and poor reporting systems. Most cases of coinfection in the Americas are reported in Brazil, where the incidence of leishmaniasis has spread in recent years due to overlap with major areas of HIV transmission. In some areas of Africa, the number of coinfection cases has increased dramatically due to social phenomena such as mass migration and wars. In northwest Ethiopia, up to 30% of all visceral leishmaniasis patients are also infected with HIV. In Asia, coinfections are increasingly being reported in India, which also has the highest global burden of leishmaniasis and a high rate of resistance to antimonial drugs. Based on the previous experience of 20 years of coinfection in Europe, this review focuses on the management of Leishmania-HIV-coinfected patients in low-income countries where leishmaniasis is endemic.

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Diagnosis of visceral leishmaniasis in HIV-infected individuals using peripheral blood smears

Cited by 66 publications

References 0 publications

Risk factors, clinical features and outcomes of visceral leishmaniasis in solid-organ transplant recipients: a retrospective multicenter case–control study

Risk factors, clinical features and outcomes of visceral leishmaniasis in solid-organ transplant recipients: a retrospective multicenter case–control study

Peripheral Blood Buffy Coat Smear: a Promising Tool for Diagnosis of Visceral Leishmaniasis

The Relationship between Leishmaniasis and AIDS: the Second 10 Years

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