Ultrasensitive real-time pcr for the clinical management of visceral leishmaniasis in HIV-infected patients

Israel Molina, Roser Fisa, Cristina Riera, Vicenc Falco, Aleix Elizalde, Fernando Salvador, Manuel Crespo, Adrian Curran, Paulo Lopez-Chejade, Silvia Tebar, Santiago Perez-Hoyos, Esteban Ribera, Albert Pahissa

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29 Citations (Scopus)

Abstract

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.
Original languageEnglish
Pages (from-to)105-110
JournalAmerican Journal of Tropical Medicine and Hygiene
Volume89
Issue number1
DOIs
Publication statusPublished - 1 Jul 2013

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