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REFERENCE VALUES FOR LEISHMANIA INFANTUM PARASITEMIA IN DIFFERENT CLINICAL PRESENTATIONS: QUANTITATIVE POLYMERASE CHAIN REACTION FOR THERAPEUTIC MONITORING AND PATIENT FOLLOW-UP

Quantification of Leishmania infantum DNA in blood samples by an ultrasensitive quantitative polymerase chain reaction (QPCR) detected parasitemias in different clinical presentations. We observed a large range of parasitemias, more than 9 log values, and could determine the threshold between asymptomatic carriage and disease in the Mediterranean area (approximately one parasite/mL of blood. Based on kinetoplast DNA amplification, this assay had a sensitivity of 0.001 parasite DNA equivalents/mL and detected asymptomatic carriage of Leishmania. It detected parasite DNA in 58% of healthy subjects, while an immunoblot detected specific antibodies in only 16%. For initial diagnosis of disease, this quantitative PCR with blood samples constitutes a non-invasive alternative to bone marrow aspiration. Its main applications are monitoring of drug therapy and follow-up of immunodeficient patients for biologic confirmation of relapses.

Received October 24, 2005. Accepted for publication March 28, 2006.

^* Address correspondence to Charles Mary, Laboratoire de Parasitologie, Hopital de la Timone, 266 Rue Saint Pierre, 13385 Marseille Cedex 5, France. E-mail: cmary{at}ap-hm.fr

Authors’ addresses: Charles Mary, Françoise Faraut, and Henri Dumon, Laboratoire de Parasitologie, Hopital de la Timone, 266 Rue Saint Pierre, 13385 Marseille Cedex 5, France, Telephone: 33-4-91-38-60-90 E-mail: cmary{at}ap-hm.fr. Marie-Pierre Drogoul, Centre d’Information et de Soins de l’Immunodéficience Humaine, Hopital Sainte Marguerite, 270, Boulevard de Ste. Marguerite, 13274 Marseille, France, Telephone: 33-4-91-74-49-66, Fax: 33-4-91-74-49-62. Bernard Xeridat, Polyclinique Clairval, 317 Boulevard du Redon, 13009 Marseille, France, Telephone: 33-4-91-17-17-17. Nicolas Schleinitz, Medecine Interne, Hopital de la Conception, 147 BD Baille, 13385 Marseille Cedex 5, France. Bernadette Cuisenier, Laboratoire de Parasitologie, Hopital du Bocage, 2 Boulevard de Lattre de Tassigny, 21034 Dijon, France, Telephone: 33-3-80-29-35-23.

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