<i>Leishmania major</i> Cutaneous Leishmaniasis in HIV-Positive Patients Does Not Spread to Extralesional Sites

Foulet, F.; Cosnes, A.; Dellion, S.; Blum, Laurent; Bachmeyer, Claude; Raguin, G; Tourte-Schaeffer, Claudine; Deniau, M.; Bretagne, Stéphane

doi:10.1001/archderm.142.10.1368

Cited by 9 publications

(6 citation statements)

References 5 publications

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“…However, the relationship is not necessarily linear. Among six African HIV-positive patients with cutaneous L. major infection seen in an outpatient clinic in France between 1997 and 2002, five had DCL and none showed parasite dissemination beyond the lesion, despite a high viral load and very low CD4 levels in the peripheral blood (Ͻ10 cells/l) (99). In DCL, where the tendency for a Th2 response is already established, synergy could emerge early with severe negative consequences for the course of leishmaniasis.…”

Section: Cl-hiv Coinfectionmentioning

confidence: 99%

“…Leishmania major was reported to cause DCL in a child with AIDS (104), in four coinfected patients with CD4 levels below 10/l, with no visceralization and no relapse after successful treatment (99), and in a severely immunocompromised patient in Burkina Faso, who failed to respond to treatment courses of amphotericin B deoxycholate (AMB), sodium stibogluconate, and liposomal AMB (L-AMB) but responded to miltefosine (234). A longitudinal study in the same country reported clinical polymorphism and a variable treatment response for 32 CL-HIV patients followed over a period of 16 months, with some patients presenting with more than one clinical form (173).…”

Section: Cl-hiv Coinfectionmentioning

confidence: 99%

“…The incubation period does not seem to be affected by HIV status (99). The impact of HAART has not been studied.…”

Section: Cl-hiv Coinfectionmentioning

confidence: 99%

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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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Section: Cl-hiv Coinfectionmentioning

confidence: 99%

Section: Cl-hiv Coinfectionmentioning

confidence: 99%

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The Relationship between Leishmaniasis and AIDS: the Second 10 Years

et al. 2008

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“…Although the clinical presentation of cutaneous leishmaniasis is influenced by the infecting species (13,22), on an individual basis, the clinical presentation is not specific enough to allow a reliable species determination (1,7,13,32). Identification of the species can also help predict the risk of dissemination in immunocompromised patients (10,11). Thus, species identification is important to determine the clinical prognosis and to select the most appropriate therapeutic regimen to be administered to each individual.…”

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confidence: 99%

Detection and Identification ofLeishmaniaSpecies from Clinical Specimens by Using a Real-Time PCR Assay and Sequencing of the CytochromebGene

Foulet¹,

Botterel²,

Buffet

et al. 2007

J Clin Microbiol

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Visceral and cutaneous leishmaniases are heterogenous entities. The Leishmania species that a given patient harbors usually cannot be determined clinically, and this identification is essential to prescribe the best species-specific therapeutic regimen. Our diagnosis procedure includes a real-time PCR assay targeted at the 18S rRNA gene, which detects all Leishmania species but which is not specific for a given Leishmania species. We developed a species identification based on sequencing of the cytochrome b (cyt b) gene directly from the DNA extracted from the clinical specimen. The sequences were analyzed using the Sequence Analysis/Seqscape v2.1 software (Applied Biosystems). This software is designed to automatically identify the closest sequences from a reference library after analysis of all known or unknown polymorphic positions. The library was built with the Leishmania cyt b gene sequences available in GenBank. Fifty-three consecutive real-time PCR-positive specimens were studied for species identification. The cyt b gene was amplified in the 53 specimens. Sequencing resulted in the identification of six different species with >99% identity with the reference sequences over 872 nucleotides. The identification was obtained in two working days and was in accordance with the multilocus enzyme electrophoresis identification when available. Real-time PCR followed by sequencing of the cyt b gene confirmed the diagnosis of leishmaniasis and rapidly determined the infecting species directly from the clinical specimen without the need for the isolation of parasites. This technique has the potential to significantly accelerate species-adapted therapeutic decisions regarding treatment of leishmaniasis.The leishmaniases are a group of parasitic diseases of major and growing public health importance (12,22). Leishmaniasis is endemic in many countries that are destinations for millions of travelers or migrant workers from Northern countries, including patients with immunodepression, each year (9). About 21 Leishmania species have been reported to cause human infection (12). Some species causing cutaneous leishmaniasis, mainly Leishmania braziliensis and to a lesser extent L. panamensis and L. guyanensis, are associated with the risk of delayed mucosal leishmaniasis, and the response to antileishmanial agents is influenced by the species (16, 23). Although the clinical presentation of cutaneous leishmaniasis is influenced by the infecting species (13, 22), on an individual basis, the clinical presentation is not specific enough to allow a reliable species determination (1, 7, 13, 32). Identification of the species can also help predict the risk of dissemination in immunocompromised patients (10, 11). Thus, species identification is important to determine the clinical prognosis and to select the most appropriate therapeutic regimen to be administered to each individual.The reference positive diagnosis methods for leishmaniasis, i.e., direct smear examination and culture, have important limitations (8). Direct examinatio...

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“…It is now well documented that CL is caused by more than 22 different species of the genus Leishmania ( L ) but their prevalence varies from region to region [3, 4]. Identification of specific L. species is important for the prescription of appropriate therapy [5]. Treatment of CL patients without identification of L. species cause harmful effects to the patients as the attribution of the relative importance of specific L. species in humans are reported [6].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Leishmania species among patients with cutaneous leishmaniasis in Qassim province of Saudi Arabia

et al. 2019

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Background Leishmaniasis is a parasitic infection endemic in more than ninety countries of the world. The cutaneous leishmaniasis (CL) is a most common form of leishmaniasis and it remains to be a major public health issue in Saudi Arabia. This study was undertaken to investigate the Leishmania species responsible for CL infection in different provinces of Qassim, Saudi Arabia. Methods Skin biopsies were obtained from CL patients and DNA was extracted using the Magna pure system. Leishmania species were identified by highly specific/sensitive quantitative and qualitative PCR. Results Out of total 206 CL biopsies, 49.5% biopsies were found to be positive for Leishmania major ( L. major ), 28.6% biopsies were positive for Leishmania tropica (L. tropica) , 3.9% were found to be positive for Leishmania infantum/donovani (L. infantum/donovani) . Not only have these, all tested CL biopsies showed negative test for Leishmania mexicana (L. mexicana) and Leishmania viannia ( L. viannia ). Conclusions This is the first comprehensive study that shows the majority of CL in Qassim was caused by L. major and L. tropica . To the best of our knowledge, this is the very first report that shows the occurrence of L. infantum/donovani in Saudi Arabia. This requires higher alert to the Ministry of Health of Saudi Arabia to take proactive actions in preventing the onset of L. major , L. tropica, L. infantum and L. donovani infections.

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Leishmania major Cutaneous Leishmaniasis in HIV-Positive Patients Does Not Spread to Extralesional Sites

Cited by 9 publications

References 5 publications

The Relationship between Leishmaniasis and AIDS: the Second 10 Years

The Relationship between Leishmaniasis and AIDS: the Second 10 Years

Detection and Identification ofLeishmaniaSpecies from Clinical Specimens by Using a Real-Time PCR Assay and Sequencing of the CytochromebGene

Prevalence of Leishmania species among patients with cutaneous leishmaniasis in Qassim province of Saudi Arabia

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