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Is Real-Time Polymerase Chain Reaction (PCR) More Useful Than a Conventional PCR for the Clinical Management of Leishmaniasis?

It is currently unknown if the use of a real-time polymerase chain reaction (PCR) adds value to the diagnosis and follow-up prognosis of patients affected by leishmaniasis. We performed a study using a real-time PCR directed against the -polymerase gene and a semiquantitative PCR that target the SSU ribosomal RNA (rRNA) gene as control for the diagnosis and quantification of parasites in patients with visceral (VL) and cutaneous (CL) leishmaniasis. Our single copy real-time PCR missed one diagnosis of VL compared with the conventional PCR, whereas both PCR methods were able to detect Leishmania parasites in CL. Under anti-leishmania treatment the kinetics of parasitemia were comparable with the two methods. The real-time PCR directed against -polymerase of Leishmania despite being able to make a more accurate quantification of parasites does not add to the decision-making management compared with a semiquantitative PCR, and it is comparatively expensive.

Received December 4, 2008. Accepted for publication March 25, 2009.

Financial support: This research was partially supported by Fondo Interno di Ricerca Scientifica e Tecnologica (FIRST), Università di Milano, 2007.

^* Address correspondence to Spinello Antinori, Department of Clinical Sciences L Sacco, section of Infectious Diseases and Immunopathology, University of Milan, Via GB Grassi 74, 20157 Milano, Italy. E-mail: spinello.antinori{at}unimi.it

Authors’ addresses: Spinello Antinori, Department of Clinical Sciences L Sacco, Section of Infectious Diseases and Immunopathology, University of Milan, Via GB Grassi 74, 20157 Milano, Italy, Tel: +390 2503 19765, Fax: +390 2503 19768, E-mail: spinello.antinori{at}unimi.it. Sara Calattini and Giovanna Bestetti, Department of Clinical Sciences L Sacco, Section of Infectious Diseases and Immunopathology, University of Milan, Via GB Grassi 74, 20157 Milano, Italy, Tel: +390 2390 43350, Fax: +390 2503 19768. Roberta Piolini and Erika Longhi, Department of Clinical Sciences L Sacco, Section of Infectious Diseases and Immunopathology, University of Milan, Via GB Grassi 74, 20157 Milano, Italy, Tel: +390 2390 42210, Fax: +390 2503 19768. Antonio Cascio, Policlinico "G. Martino", University of Messina, Via Consolare Valeria, 98122 Messina, Italy, Tel: +390 9022 13680, Fax: +390 9022 13682. Carlo Parravicini, Department of Clinical Sciences L Sacco, Section of Infectious Diseases and Immunopathology, University of Milan, Via GB Grassi 74, 20157 Milano, Italy, Tel: +390 2390 42350, Fax: +390 2382 00385. Mario Corbellino, Department of Clinical Sciences L Sacco, Section of Infectious Diseases and Immunopathology, University of Milan, Via GB Grassi 74, 20157 Milano, Italy, Tel: +390 2390 42583, Fax: +390 2503 19768.