HIV-associated visceral leishmaniasis

Pintado, Vicente; López‐Vélez, Rogelio

doi:10.1046/j.1198-743x.2001.00262.x

Cited by 77 publications

(81 citation statements)

References 43 publications

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“…Microscopic observation of bone marrow aspirate is very specific (100%), but sensitivity has been reported between 67% and 94% 9,24 . Several reasons have been cited for the limited sensitivity: a low number of Leishmania-infected cells as a consequence of pancytopenia; a hemodiluted sample due to inadequate collection or a low parasite load when the patient has already started therapy 20,30 .…”

Section: Discussionmentioning

confidence: 99%

“…This finding may be explained by a high prevalence of VL in the area. Due to the low sensitivity of bone marrow aspirate (67-94%), 9,24 it is possible that patients with positive serology and negative aspirate actually had VL. The use of KAtex can, however, increase the sensitivity for the diagnosis of active disease 12,13 .…”

Section: Discussionmentioning

confidence: 99%

“…Febrile splenomegaly and cytopenia in HIV-infected patients may also be observed in tuberculosis 26 , histoplasmosis 8 and lymphoma 23 . Cytopenias are frequent during the course of HIV infection and may result from several mechanisms 24 . In addition, is important to be alert for possible situations of co-infection where manifestations of VL are atypically presented 28 .…”

Section: Discussionmentioning

confidence: 99%

“…Visceral leishmaniasis may be the first infection related in 13% up to 47% of HIV-infected patients 22,24 . It is important to make an early diagnosis and monitor the development of leishmaniasis in HIV-infected patients, since these cases are less responsive to treatment and have higher fatality rates 30 .…”

Section: Discussionmentioning

confidence: 99%

“…In HIV-infected patients, visceral leishmaniasis (VL) accelerates the onset of AIDS and the disease can progress rapidly into severe forms 22,24 . HIV-VL co-infection may appear clinically in its classical form or with very aggressive characteristics, sometimes non-specific and difficult to diagnose 29 .…”

Section: Introductionmentioning

confidence: 99%

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Diagnosing visceral leishmaniasis and HIV/AIDS co-infection: a case series study in Pernambuco, Brazil

Cavalcanti

Medeiros

Lopes

et al. 2012

Rev. Inst. Med. trop. S. Paulo

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HIV/AIDS-associated visceral leishmaniasis may display the characteristics of an aggressive disease or without specific symptoms at all, thus making diagnosis difficult. The present study describes the results of diagnostic tests applied to a series of suspected VL cases in HIV-infected/AIDS patients admitted in referral hospitals in Pernambuco, Brazil. From a total of 14 eligible patients with cytopenias and/or fever of an unknown etiology, and indication of bone marrow aspirate, 10 patients were selected for inclusion in the study. Diagnosis was confirmed by the following examinations: Leishmania detection in bone marrow aspirate, direct agglutination test, indirect immunofluorescence, rK39 dipstick test, polymerase chain reaction and latex agglutination test. Five out of the ten patients were diagnosed with co-infection. A positive direct agglutination test was recorded for all five co-infected patients, the Leishmania detection and latex agglutination tests were positive in four patients, the rK39 dipstick test in three, the indirect immunofluorescence in two and a positive polymerase chain reaction was recorded for one patient. This series of cases was the first to be conducted in Brazil using this set of tests in order to detect co-infection. However, no consensus has thus far been reached regarding the most appropriate examination for the screening and monitoring of this group of patients.

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