Quantification of Leishmania infantum Kinetoplast DNA for Monitoring the Response to Meglumine Antimoniate Therapy in Visceral Leishmaniasis

Pourabbas, Bahman; Moghadam, Abdolkarim Ghadimi; Pouladfar, Gholamreza; Rezaee, Zahra; Alborzi, Abdolvahab

doi:10.4269/ajtmh.12-0440

Cited by 25 publications

(26 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…L. infantum (Pourabbas et al, 2013;Mary et al, 2006;Moral et al, 2002;Biglino et al, 2010), and L. donovani (Miller et al, 2014; have been detected in blood in up to 58% of asymptomatic infections by a cross-sectional study. 14% of 4,695 asymptomatic Ethiopians were qPCR-positive in blood of which 3.2% had high genome equivalent counts (Miller et al, 2014), suggesting that distribution of parasitaemias is skewed and that perhaps the small proportion of asymptomatic infections with higher parasitaemia are more likely to develop disease and have a disproportional role in onward transmission.…”

Section: Transmission: Xenodiagnosis Vs Tissue and Blood Parasite Loadsmentioning

confidence: 98%

“…Leishmania burdens in treated VL patients generally decline during treatment (reviewed by Kip et al, 2014; see also Pourabbas et al, 2013;Mourão et al, 2014;Mary et al, 2004Mary et al, , 2006Aoun et al, 2009;Sudarshan et al, 2011). However inadequate drugs, doses and durations may result in parasite persistence (e.g.…”

Section: Parasite Loads In Response To Treatmentmentioning

confidence: 99%

See 1 more Smart Citation

Progress in the Mathematical Modelling of Visceral Leishmaniasis

Rock¹,

Quinnell²,

Medley³

et al. 2016

Advances in Parasitology

View full text Add to dashboard Cite

The leishmaniases comprise a complex of diseases characterised by clinical outcomes that range from self-limiting to chronic, disfiguring and stigmatising, to life-threatening. Diagnostic methods, treatments, and vector and reservoir control options exist, but deciding the most effective interventions requires a quantitative understanding of the population level infection and disease dynamics. The effectiveness of any set of interventions has to be determined within the context of operational conditions, including economic and political commitment. Mathematical models are the best available tools for studying quantitative systems crossing disciplinary spheres (biology, medicine, economics) within environmental and societal constraints.In 2005, the World Health Assembly and government health ministers of India, Nepal, and Bangladesh signed a Memorandum of Understanding to eliminate the life threatening form of leishmaniasis, visceral leishmaniasis (VL), on the Indian subcontinent by 2015 through a combination of early case detection, improved treatments, and vector control. The elimination target is <1/10,000 population at the district or subdistrict level compared to the current 20/10,000 in the regions of highest transmission.Towards this goal, this chapter focuses on mathematical models of VL, and the biology driving those models, to enable realistic predictions of the * Corresponding author Email address: orin.courtenay@warwick.ac.uk (Orin Courtenay)Preprint submitted to Advances in Parasitology July 18, 2016 best combination of interventions. Several key issues will be discussed which have affected previous modelling of VL and the direction future modelling may take. Current understanding of the natural history of disease, immunity (and loss of immunity), as well as stages of infection and their durations are considered particularly for humans, but also for dogs. Asymptomatic and clinical infection are discussed in the context of their relative roles in Leishmania transmission, as well as key components of the parasite-sandfly-vector interaction and intervention strategies including diagnosis, treatment and vector control. Gaps in current biological knowledge and potential avenues to improve model structures and mathematical predictions are identified. Underpinning the marriage between biology and mathematical modelling, the content of this chapter represents the first step towards developing the next generation of models for VL.

show abstract

Section: Transmission: Xenodiagnosis Vs Tissue and Blood Parasite Loadsmentioning

confidence: 98%

Section: Parasite Loads In Response To Treatmentmentioning

confidence: 99%

Progress in the Mathematical Modelling of Visceral Leishmaniasis

Rock¹,

Quinnell²,

Medley³

et al. 2016

Advances in Parasitology

View full text Add to dashboard Cite

show abstract

“…A rapid decrease in L. infantum kinetoplast DNA loads in the blood, evaluated using real-time polymerase chain reaction (PCR) assay, was also observed with defervescence during treatment with Glucantime. 26 A good correlation between peripheral blood parasite load detected by quantitative PCR and splenic parasite score has also been recently shown. 29 In the third phase of the study, the failure rates including both failure of initial response and relapse were as high as 24% among patients receiving Glucantime, despite no failure rate in phase two.…”

Section: Discussionmentioning

confidence: 99%

“…It has been documented that the few remaining organisms that survive after treatment will be trapped by the immune system. [26][27][28] To assure complete parasite control after defervescence, in this study we continued Glucantime for another week. A rapid decrease in L. infantum kinetoplast DNA loads in the blood, evaluated using real-time polymerase chain reaction (PCR) assay, was also observed with defervescence during treatment with Glucantime.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Short-Course Meglumine Antimoniate (Glucantime®) for Treatment of Visceral Leishmaniasis: A 13-Year, Multistage, Non-Inferiority Study in Iran

Alborzi

Pouladfar

Attar

et al. 2017

The American Society of Tropical Medicine and Hygiene

Self Cite

View full text Add to dashboard Cite

Abstract. The World Health Organization's (WHO) recommendation is 28-day course of meglumine antimoniate (Glucantime ® , Sanofi Aventis, France) for the treatment of visceral leishmaniasis (VL). The aim of this study was to evaluate the effectiveness of a shorter duration of treatment in regions with low level of resistance to Glucantime. During 13 years, this study was conducted in three phases on 392 patients. In the pilot first phase, we performed splenic punctures in seven patients to assess the correlation between the changes in the parasite load during treatment with Glucantime and defervescence. With defervescence, parasite density was dramatically dropped (P = 0.014), propounding defervescence as a marker of parasitological response. On the basis of the results, we conducted a randomized trial on 75 patients, comparing the efficacy of continuation of Glucantime therapy for 1, 2, or 3 weeks after defervescence. The treatment course of 1 week after defervescence (mean = 11.7 days) was non-inferior to that of 3 weeks (final cure rate, 96% versus 100%; P = 0.023). The third phase was a retrospective cohort study of 302 patients treated either with the WHO's regimen or for 7 days after defervescence (intervention group). Relapse was detected in 8.3% patients of the intervention group and in 5% patients following the WHO's regimen (P = 0.006 for non-inferiority). The final duration of treatment in intervention group was significantly shorter than standard course (13.3 ± 2.6 versus 28 days; P < 0.001). In summary, treatment of VL with Glucantime for 1 week after defervescence was non-inferior to and appears to be an acceptable alternative to the standard 28-day course for patients in Iran who show a response to antimonial therapy.

show abstract

“…Os métodos moleculares têm sido desenvolvidos com objetivo de complementar e criar alternativas para o diagnóstico de leishmaniose, bem como possibilidade de seguimento e controle laboratorial de cura (Pourabbas et al, 2013;De Ruiter et al, 2014;De Paiva-Cavalcanti et al, 2015). Apesar do bom desempenho desses métodos para o diagnóstico de LV em pacientes com doença clinicamente manifesta, com sensibilidade e especificidade em torno de 92% e 96%, respectivamente (Cota et al, 2012), o uso desses métodos moleculares para o diagnóstico da infecção assintomática por Leishmania em estudos de frequência é outro ponto que deve ser discutido.…”

Section: Discussionunclassified

Frequência da infecção por Leishmania spp. em pacientes com HIV/aids vivendo em área urbana

Cunha¹

View full text Add to dashboard Cite

Quantification of Leishmania infantum Kinetoplast DNA for Monitoring the Response to Meglumine Antimoniate Therapy in Visceral Leishmaniasis

Cited by 25 publications

References 23 publications

Progress in the Mathematical Modelling of Visceral Leishmaniasis

Progress in the Mathematical Modelling of Visceral Leishmaniasis

Effectiveness of Short-Course Meglumine Antimoniate (Glucantime®) for Treatment of Visceral Leishmaniasis: A 13-Year, Multistage, Non-Inferiority Study in Iran

Frequência da infecção por Leishmania spp. em pacientes com HIV/aids vivendo em área urbana

Contact Info

Product

Resources

About