Contribution of Quantitative Real-Time Polymerase Chain Reaction to Follow-Up of Visceral Leishmaniasis Patients Treated with Meglumine Antimoniate

Karim Aoun Research Laboratory of Emerging Parasitic Diseases, Tunis, Tunisia; Laboratory of Parasitology and Mycology, and Department of Medical Epidemiology and Statistics, Pasteur Institute, Tunis, Tunisia; Department of Paediatrics, Kairouan, Tunisia; Laboratory of Micro-organisms and Active Bio-molecules, University of Sciences, Tunis, Tunisia; Laboratory of Parasitology and Mycology, La Timone Hospital, Marseille, France

Search for other papers by Karim Aoun in
Current site
Google Scholar
PubMed
Close
,
Emira Chouihi Research Laboratory of Emerging Parasitic Diseases, Tunis, Tunisia; Laboratory of Parasitology and Mycology, and Department of Medical Epidemiology and Statistics, Pasteur Institute, Tunis, Tunisia; Department of Paediatrics, Kairouan, Tunisia; Laboratory of Micro-organisms and Active Bio-molecules, University of Sciences, Tunis, Tunisia; Laboratory of Parasitology and Mycology, La Timone Hospital, Marseille, France

Search for other papers by Emira Chouihi in
Current site
Google Scholar
PubMed
Close
,
Fethi Amri Research Laboratory of Emerging Parasitic Diseases, Tunis, Tunisia; Laboratory of Parasitology and Mycology, and Department of Medical Epidemiology and Statistics, Pasteur Institute, Tunis, Tunisia; Department of Paediatrics, Kairouan, Tunisia; Laboratory of Micro-organisms and Active Bio-molecules, University of Sciences, Tunis, Tunisia; Laboratory of Parasitology and Mycology, La Timone Hospital, Marseille, France

Search for other papers by Fethi Amri in
Current site
Google Scholar
PubMed
Close
,
Nissaf Ben Alaya Research Laboratory of Emerging Parasitic Diseases, Tunis, Tunisia; Laboratory of Parasitology and Mycology, and Department of Medical Epidemiology and Statistics, Pasteur Institute, Tunis, Tunisia; Department of Paediatrics, Kairouan, Tunisia; Laboratory of Micro-organisms and Active Bio-molecules, University of Sciences, Tunis, Tunisia; Laboratory of Parasitology and Mycology, La Timone Hospital, Marseille, France

Search for other papers by Nissaf Ben Alaya in
Current site
Google Scholar
PubMed
Close
,
Ali Raies Research Laboratory of Emerging Parasitic Diseases, Tunis, Tunisia; Laboratory of Parasitology and Mycology, and Department of Medical Epidemiology and Statistics, Pasteur Institute, Tunis, Tunisia; Department of Paediatrics, Kairouan, Tunisia; Laboratory of Micro-organisms and Active Bio-molecules, University of Sciences, Tunis, Tunisia; Laboratory of Parasitology and Mycology, La Timone Hospital, Marseille, France

Search for other papers by Ali Raies in
Current site
Google Scholar
PubMed
Close
,
Charles Mary Research Laboratory of Emerging Parasitic Diseases, Tunis, Tunisia; Laboratory of Parasitology and Mycology, and Department of Medical Epidemiology and Statistics, Pasteur Institute, Tunis, Tunisia; Department of Paediatrics, Kairouan, Tunisia; Laboratory of Micro-organisms and Active Bio-molecules, University of Sciences, Tunis, Tunisia; Laboratory of Parasitology and Mycology, La Timone Hospital, Marseille, France

Search for other papers by Charles Mary in
Current site
Google Scholar
PubMed
Close
, and
Aida Bouratbine Research Laboratory of Emerging Parasitic Diseases, Tunis, Tunisia; Laboratory of Parasitology and Mycology, and Department of Medical Epidemiology and Statistics, Pasteur Institute, Tunis, Tunisia; Department of Paediatrics, Kairouan, Tunisia; Laboratory of Micro-organisms and Active Bio-molecules, University of Sciences, Tunis, Tunisia; Laboratory of Parasitology and Mycology, La Timone Hospital, Marseille, France

Search for other papers by Aida Bouratbine in
Current site
Google Scholar
PubMed
Close
Restricted access

Forty-two patients with visceral leishmaniasis in Tunisia were treated with meglumine antimoniate and followed-up for clinical improvement and blood parasite load determined by quantitative real-time polymerase chain reaction (PCR). Parasite loads before treatment ranged from 27 to 5.3 × 107 parasites/mL. At the end of treatment, parasite load decreased significantly in 39 cured patients (P < 0.001). The decrease in parasite load after treatment was greater than 99% for 34 patients and PCR results became negative in 23 of them. Two patients without clinical improvement showed no or slight decreases in parasite load (209 versus 202 parasites/mL and 1,765 versus 146 parasites/mL). One patient showed had a relapse seven months after showing a good response to treatment. His parasitemia remained high despite a sharp decrease (5.2 × 105 versus 5.9 × 103 parasites/mL).

Author Notes

  • 1

    Abdelmoula MS, M’Hamdi Z, Amri F, Tebib N, Ben Turkia F, Ben Dridi MF, 2003. La leishmaniose viscérale chez l’enfant: facteurs pronostiques. Tunis Med 81 :535–539.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2

    Bouratbine A, Aoun K, Chahed MD, Ben Ismail R, 1998. Données épidémiologiques sur la leishmaniose viscérale infantile en Tunisie en 1993. Med Mal Infect 28 :446–447.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3

    Aoun K, Bouratbine A, 2008. Leishmaniasis. Rakel ER, Bope ET, eds. Conn’s Current Therapy 2008. Philadelphia: Saunders Elsevier, 94–98.

    • PubMed
    • Export Citation
  • 4

    Mary C, Farault F, Lascombe L, Dumon H, 2004. Quantification of Leishmania infantum DNA by a real-time PCR assay with high sensitivity. J Clin Microbiol 42 :5249–5255.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5

    Antinori S, Calattini S, Piolini R, Longhi E, Bestetti G, Cacsio A, Parravicini C, Gorbellini M, 2009. Is real-time PCR more useful than a conventional PCR for the clinical management of leishmaniasis. Am J Trop Med Hyg 81 :46–51.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6

    Mary C, Farault F, Droguoul MP, Xeridat B, Scleinitz N, Cuisenier, 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 :858–863.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7

    Rioux JA, Lanotte G, Serres E, Pratlong F, Bastien P, Périères J, 1990. Taxonomy of Leishmania: use of isoenzymes and suggestion for a new classification. Ann Parasitol Hum Comp 65 :111–125.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8

    Desjeux P, 2005. Therapeutic options for visceral leishmaniasis. Med Mal Infect 35 :74–76.

  • 9

    Cascio A, Calattini S, Colomba C, Scalmonia C, Galazzi M, Pizzuto M, Camilli R, Gramiccia M, Titone L, Gorbellini M, Antinori S, 2002. Polymerase chain reaction in the diagnosis and prognosis of Mediterranean visceral leishmaniasis in immunocompetent children. Pediatrics 109 :E27.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10

    Cruz I, Chicharro C, Nieto J, Bailo B, Canavate C, Figueras MC, Alvar J, 2006. Comparison of new diagnostic tools for management of pediatric Mediterranean visceral leishmaniasis. J Clin Microbiol 44 :2343–2347.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11

    Gradoni L, Gramiccia M, Pettoello M, Di Martino L, Nocerino A, 1987. A new Leishmania infantum enzymatic variant, agent of visceral leishmaniasis case unresponsive to drugs. Trans R Soc Trop Med Hyg 81 :927–928.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12

    Faraut-Gambarelli F, Piarroux R, Deniau M, Giusiano B, Marty P, Michel G, Faugère B, Dumon H, 1997. In vivo and in vitro resistance of Leishmania infantum to meglumine antimoniate: a study of 37 strains collected from patients with visceral leishmaniasis. Antimicrob Agents Chemother 41 :827–830.

    • PubMed
    • Search Google Scholar
    • Export Citation
Past two years Past Year Past 30 Days
Abstract Views 44 44 8
Full Text Views 365 47 0
PDF Downloads 58 12 0
 
Membership Banner
 
 
 
Affiliate Membership Banner
 
 
Research for Health Information Banner
 
 
CLOCKSS
 
 
 
Society Publishers Coalition Banner
Save