TY - JOUR
T1 - Ultrasensitive real-time pcr for the clinical management of visceral leishmaniasis in HIV-infected patients
AU - Molina, Israel
AU - Fisa, Roser
AU - Riera, Cristina
AU - Falco, Vicenc
AU - Elizalde, Aleix
AU - Salvador, Fernando
AU - Crespo, Manuel
AU - Curran, Adrian
AU - Lopez-Chejade, Paulo
AU - Tebar, Silvia
AU - Perez-Hoyos, Santiago
AU - Ribera, Esteban
AU - Pahissa, Albert
PY - 2013/7/1
Y1 - 2013/7/1
N2 - Molecular methods have been proposed as an alternative tool for the diagnosis of visceral leishmaniasis (VL), but no data are available regarding use for monitoring clinical outcome. A prospective cohort study of human immunodeficiency virus-(HIV) and VL-coinfected patients was conducted in a university-affiliated hospital in Barcelona, Spain. Leishmania parasite load was monitored using a real-time polymerase chain reaction (PCR) at baseline and every 3 months. Cutoff values for PCR were determined using receiver operating characteristic (ROC) curves. Overall, 37 episodes were analyzed, and 25 of these episodes were considered as relapsing episodes. A significant decrease of parasite load measured 3 months after treatment could predict the clinical evolution of VL. A parasite load over 0.9 parasites/mL measured 12 months after treatment could predicts relapse with a sensitivity of 100% and a specificity of 90.9%. Monitoring parasite load by an ultrasensitive quantitative Leishmania PCR is useful to predict the risk of relapse after a VL episode in HIV-infected patients.© 2013 by The American Society of Tropical.
AB - Molecular methods have been proposed as an alternative tool for the diagnosis of visceral leishmaniasis (VL), but no data are available regarding use for monitoring clinical outcome. A prospective cohort study of human immunodeficiency virus-(HIV) and VL-coinfected patients was conducted in a university-affiliated hospital in Barcelona, Spain. Leishmania parasite load was monitored using a real-time polymerase chain reaction (PCR) at baseline and every 3 months. Cutoff values for PCR were determined using receiver operating characteristic (ROC) curves. Overall, 37 episodes were analyzed, and 25 of these episodes were considered as relapsing episodes. A significant decrease of parasite load measured 3 months after treatment could predict the clinical evolution of VL. A parasite load over 0.9 parasites/mL measured 12 months after treatment could predicts relapse with a sensitivity of 100% and a specificity of 90.9%. Monitoring parasite load by an ultrasensitive quantitative Leishmania PCR is useful to predict the risk of relapse after a VL episode in HIV-infected patients.© 2013 by The American Society of Tropical.
U2 - 10.4269/ajtmh.12-0527
DO - 10.4269/ajtmh.12-0527
M3 - Article
VL - 89
SP - 105
EP - 110
IS - 1
ER -
