Volume 89, Issue 1
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



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. 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 PCR is useful to predict the risk of relapse after a VL episode in HIV-infected patients.


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  1. Ribera E, Ocaña I, de Otero J, Cortes E, Gasser I, Pahissa A, , 1996. Prophylaxis of visceral leishmaniasis in human immunodeficiency virus infected patients. Am J Med 10: 496501.[Crossref]
  2. Ribera E, Cucurull E, Ocana I, Vallespí T, Gasser I, Juste C, , 1995. Visceral leishmaniasis in patients with HIV infection. Enferm Infecc Microbiol Clin 13: 7379.
  3. Mira JA, Corzo JE, Rivero A, Macias J, De Leon FL, Torre-Cisneros J, Gómez-Mateos J, Jurado R, Pineda JA, , 2004. Frequency of visceral leishmaniasis relapses in human immunodeficiency virus-infected patients receiving highly active antiretroviral therapy. Am J Trop Med Hyg 70: 298301.
  4. Fernández-Cotarelo MJ, Martínez Abellan J, Vales Guerra JM, Martínez Sánchez P, Rodrigo Gómez De La Bárcena M, Salto Fernandez E, , 2003. Effect of highly active antiretroviral therapy on the incidence and clinical manifestations of visceral leishmaniasis in human immunodeficiency virus-infected patients. Clin Infect Dis 37: 973977.[Crossref]
  5. Molina I, Falcó V, Crespo M, Riera C, Ribera E, Curran A, Carrio J, Diaz M, Villar del Saz S, Fisa R, López-Chejade P, Ocaña I, Pahissa A, , 2007. Efficacy of liposomal amphotericin B for secondary prophylaxis of visceral leishmaniasis in HIV-infected patients. J Antimicrob Chemother 60: 837842.[Crossref]
  6. Allahverdiyev AM, Bagirova M, Uzun S, Alabaz D, Aksaray N, Kocabas E, Koksal F, , 2005. The value of a new microculture method for diagnosis of visceral leishmaniasis by using bone marrow and peripheral blood. Am J Trop Med Hyg 73: 276280.
  7. Mathis A, Deplazes P, , 1995. PCR and in vitro cultivation for detection of Leishmania spp. in diagnostic samples from human and dogs. J Clin Microbiol 33: 11451149.
  8. Piarroux R, Gambarelli F, Toga B, Dumon H, Fontes M, Dunan S, Quilici M, , 1996. Interest and reliability of a polymerase chain reaction on bone marrow samples in the diagnosis of visceral leishmaniasis in AIDS. AIDS 10: 452453.[Crossref]
  9. Costa JM, Durand R, Deniau M, Rivollet D, Izri M, Houin R, Vidaud M, Bretagne S, , 1996. PCR enzyme-linked immunosorbent assay for diagnosis of leishmaniasis in human immunodeficiency virus–infected patients. J Clin Microbiol 34: 18311833.
  10. Campino L, Cortes S, Pires R, Oskam L, Abranches P, , 2000. Detection of Leishmania in immunocompromised patients using peripheral blood spots on filter paper and the polymerase chain reaction. Eur J Clin Microbiol Infect Dis 19: 396398.[Crossref]
  11. Pizzuto M, Piazza M, Senese D, Scalamogna C, Calattini S, Corsico L, Persico T, Adriani B, Magni C, Guaraldi G, Gaiera G, Ludovisi A, Gramiccia M, Galli M, Moroni M, Corbellino M, Antinori S, , 2001. Role of PCR in diagnosis and prognosis of visceral leishmaniasis in patients coinfected with human immunodeficiency virus type 1. J Clin Microbiol 39: 357361.[Crossref]
  12. Fisa R, Riera C, Ribera E, Gallego M, Portus M, , 2002. A nested polymerase chain reaction for diagnosis and follow-up of human visceral leishmaniasis patients using blood samples. Trans R Soc Trop Med Hyg 96 (Suppl 1): S191S194.[Crossref]
  13. Cruz I, Canavate C, Rubio JM, Morales MA, Chicharro C, Laguna F, Jiménez-Mejías M, Sirera G, Videla S, Alvar J, , 2002. A nested polymerase chain reaction (Ln-PCR) for diagnosing and monitoring Leishmania infantum in patients coinfected with human immunodeficiency virus. Trans R Soc Trop Med Hyg 96 (Suppl 1): S185S189.[Crossref]
  14. Martin-Sanchez J, Pineda JA, Andreu-Lopez M, Delgado J, Macías J, De la Rosa L, Morillas-Márquez F, , 2002. The high sensitivity of a PCR-ELISA in the diagnosis of cutaneous and visceral leishmaniasis caused by Leishmania infantum . Ann Trop Med Parasitol 96: 669677.[Crossref]
  15. Deniau M, Canavate C, Faraut-Gambarelli F, Marty P, , 2003. The biological diagnosis of leishmaniasis in HIV-infected patients. Ann Trop Med Parasitol 97 (Suppl 1): S115S133.[Crossref]
  16. Bossolasco S, Gaiera G, Olchini D, Gulletta M, Martello L, Bestetti A, Bossi L, Germagnoli L, Lazzarin A, Uberti-Foppa C, Cinque P, , 2003. Real-time PCR assay for clinical management of human immunodeficiency virus–infected patients with visceral leishmaniasis. J Clin Microbiol 41: 50805084.[Crossref]
  17. Fissore C, Delaunay P, Ferrua B, Rosenthal E, Del Giudice P, Aufeuvre JP, Le Fichoux Y, Marty P, , 2004. Convenience of serum for visceral leishmaniasis diagnosis by PCR. J Clin Microbiol 42: 53325333.[Crossref]
  18. Gatti S, Gramegna M, Klersy C, Madama S, Bruno A, Maserati R, Bernuzzi AM, Cevini C, Scaglia M, , 2004. Diagnosis of visceral leishmaniasis: the sensitivities and specificities of traditional methods and a nested PCR assay. Ann Trop Med Parasitol 98: 667676.[Crossref]
  19. Lachaud L, Dereure J, Chabbert E, Reynes J, Mauboussin JM, Oziol E, Dedet JP, Bastien P, , 2000. Optimized PCR using patient blood samples for diagnosis and follow-up of visceral Leishmaniasis, with special reference to AIDS patients. J Clin Microbiol 38: 236240.
  20. Antinori S, Calattini S, Piolini R, Longhi E, Bestetti G, Piolini R, Magni C, Orlando G, Gramiccia M, Acquaviva V, Foschi A, Corvasce S, Colomba C, Titone L, Parravicini C, Cascio A, Corbellino M, , 2009. Is real-time polymerase chain reaction (PCR) more useful than a conventional PCR for the clinical management of leishmaniasis? Am J Trop Med Hyg 81: 4651.
  21. Mary C, Faraut F, Lascombe L, Dumon H, , 2004. Quantification of Leishmania infantum DNA by a real-time PCR assay with high sensitivity. J Clin Microbiol 42: 52495255.[Crossref]
  22. Riera C, Fisa R, Ribera E, Carrió J, Falcó V, Gállego M, Moner L, Molina I, Portús M, , 2005. Value of culture and nested PCR of blood in the prediction of relapses in patients co-infected with Leishmania and HIV. Am J Trop Med Hyg 73: 10121015.
  23. Mary C, Faraut F, Drogoul MP, Xeridat B, Schleinitz N, Cuisenier B, Dumon H, , 2006. Reference values for Leishmania infantum parasitemia in different clinical presentations: quantitative polymerase chain reaction for therapeutic monitoring and patient follow-up. Am J Trop Med Hyg 75: 858863.
  24. Antinori S, Calattini S, Longhi E, Bestetti G, Piolini R, Magni C, Orlando G, Gramiccia M, Acquaviva V, Foschi A, Corvasce S, Colomba C, Titone L, Parravicini C, Cascio A, Corbellino M, , 2007. Clinical use of polymerase chain reaction performed on peripheral blood and bone marrow samples for the diagnosis and monitoring of visceral leishmaniasis in HIV-infected and HIV-uninfected patients: a single-center, 8-year experience in Italy and review of the literature. Clin Infect Dis 44: 16021610.[Crossref]
  25. Bourgeois N, Lachaud L, Reynes J, Rouanet I, Mahamat A, Bastien P, , 2008. Long-term monitoring of visceral leishmaniasis in patients with AIDS: relapse risk factors, value of polymerase chain reaction, and potential impact on secondary prophylaxis. J Acquir Immune Defic Syndr 48: 1319.[Crossref]
  26. Gutiérrez J, Maroto MC, Piédrola G, Higuera A, , 1993. Prevalence of anti-Leishmania antibodies in parenteral drug addicts. Yield value of 2 study techniques. Med Clin (Barc) 100: 168170.
  27. Riera C, Fisa R, López-Chejade P, Serra T, Girona E, Jiménez M, Muncunill J, Sedeño M, Mascaró M, Udina M, Gállego M, Carrió J, Forteza A, Portús M, , 2008. Asymptomatic infection by Leishmania infantum in blood donors from the Balearic Islands (Spain). Transfusion 48: 13831389.[Crossref]
  28. Riera C, Fisa R, Udina M, Gállego M, Portus M, , 2004. Detection of Leishmania infantum cryptic infection in asymptomatic blood donors living in an endemic area (Eivissa, Balearic Islands, Spain) by different diagnostic methods. Trans R Soc Trop Med Hyg 98: 102110.[Crossref]
  29. García-García JA, Martín-Sánchez J, Gállego M, Rivero-Román A, Camacho A, Riera C, Morillas-Márquez F, Vergara S, Macías J, Pineda JA, , 2006. Use of noninvasive markers to detect Leishmania infection in asymptomatic human immunodeficiency virus-infected patients. J Clin Microbiol 44: 44554458.[Crossref]
  30. Riera C, Fisa R, Lopez P, Ribera E, Carrió J, Falcó V, Molina I, Gállego M, Portús M, , 2004. Evaluation of a latex agglutination test (KAtex) for detection of Leishmania antigen in urine of patients with HIV-Leishmania coinfection: value in diagnosis and post-treatment follow-up. Eur J Clin Microbiol Infect Dis 23: 899904.
  31. Alvar J, Aparicio P, Aseffa A, Den Boer M, Cañavate C, Dedet JP, Gradoni L, Ter Horst R, López-Vélez R, Moreno J, , 2008. The relationship between leishmaniasis and AIDS: the second 10 years. Clin Microbiol Rev 21: 334359.[Crossref]
  32. Bourgeois N, Bastien P, Reynes J, Makinson A, Rouanet I, Lachaud L, , 2010. ‘Active chronic visceral leishmaniasis’ in HIV-1-infected patients demonstrated by biological and clinical long-term follow-up of 10 patients. HIV Med 11: 670673.[Crossref]
  33. Colomba C, Saporito L, Vitale F, Reale S, Vitale G, Casuccio A, Tolomeo M, Maranto D, Rubino R, Di Carlo P, Titone L, , 2009. Cryptic Leishmania infantum infections in Italian HIV infected patients. BMC Infect Dis 9: 199.[Crossref]

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  • Received : 27 Aug 2012
  • Accepted : 21 Jan 2013

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