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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

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  • 1 Laboratoire de Parasitologie, Hopital de la Timone, Marseille, France; Centre d’Information et de Soins de l’Immunodéficience Humaine, Hopital Sainte Mrguerite, Marseille, France; Polyclinique Clairval, Marseille, France; Medecine Interne, Hopital de la Conception, Marseille, France; Laboratoire de Parasitologie, Hopital du Bocage, Dijon, France
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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.

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