Desjeux P, Alvar J, 2003. Leishmania/HIV co-infections: epidemiology in Europe. Ann Trop Med Parasitol 97 (Suppl 1): 3–15.
Alvar J, Aparicio P, Aseffa A, Den Boer M, Canavate C, Dedet J-P, Gradoni L, Ter Horst R, Lopez-Velez R, Moreno J, 2008. The relationship between leishmaniasis and AIDS: the second 10 years. Clin Microbiol Rev 21: 334–359.
Alvar J, Vélez ID, Bern C, Herrero M, Desjeux P, Cano J, Jannin J, den Boer M; WHO Leishmaniasis Control Team, 2012. Leishmaniasis worldwide and global estimates of its incidence. PLoS One 7: e35671.
Faucher B, Piarroux R, 2011. Actualités sur les leishmanioses viscérales. Rev Med Interne 32: 544–551.
Okwor I, Uzonna JE, 2013. The immunology of Leishmania/HIV co-infection. Immunol Res 56: 163–171.
Casado JL, Abad-Fernández M, Moreno S, Pérez-Elías MJ, Moreno A, Bernardino JI, Vallejo A, 2015. Visceral leishmaniasis as an independent cause of high immune activation, T-cell senescence, and lack of immune recovery in virologically suppressed HIV-1-coinfected patients. HIV Med 16: 240–248.
Molina R, Gradoni L, Alvar J, 2003. HIV and the transmission of Leishmania. Ann Trop Med Parasitol 97 (Suppl 1): 29–45.
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: 670–673.
Lima IP, Müller MC, Holanda TA, Harhay M, Costa CHN, Costa DL, 2013. Human immunodeficiency virus/Leishmania infantum in the first foci of urban American visceral leishmaniasis: clinical presentation from 1994 to 2010. Rev Soc Bras Med Trop 46: 156–160.
Srivastava P, Dayama A, Mehrotra S, Sundar S, 2011. Diagnosis of visceral leishmaniasis. Trans R Soc Trop Med Hyg 105: 1–6.
Cota GF, de Sousa MR, de Freitas Nogueira BM, Gomes LI, Oliveira E, Assis TSM, de Mendonça ALP, Pinto BF, Saliba JW, Rabello A, 2013. Comparison of parasitological, serological, and molecular tests for visceral leishmaniasis in HIV-infected patients: a cross-sectional delayed-type study. Am J Trop Med Hyg 89: 570–577.
El Harith A, Kolk AHJ, Leewenburg J, Muigai R, Huigen E, Jelsma T, Kager P, 1988. Improvement of a direct agglutination test for field studies of visceral leishmaniasis. J Clin Microbiol 26: 1321–1325.
Schönian G, Nasereddin A, Dinse N, Schweynoch C, Schallig HDF, Presber W, Jaffe CL, 2003. PCR diagnosis and characterization of Leishmania in local and imported clinical samples. Diagn Microbiol Infect Dis 47: 349–358.
Carranza-Tamayo CO, de Assis TSM, Neri ATB, Cupolillo E, Rabello A, Romero GAS, 2009. Prevalence of Leishmania infection in adult HIV/AIDS patients treated in a tertiary-level care center in Brasilia, Federal District, Brazil. Trans R Soc Trop Med Hyg 103: 743–748.
Orsini M, Canela JR, Disch J, Maciel F, Greco D, Toledo A, Rabello A, 2012. High frequency of asymptomatic Leishmania spp. infection among HIV-infected patients living in endemic areas for visceral leishmaniasis in Brazil. Trans R Soc Trop Med Hyg 106: 283–288.
Monge-Maillo B, Norman FF, Cruz I, Alvar J, López-Vélez R, 2014. Visceral leishmaniasis and HIV coinfection in the mediterranean region. PLoS Negl Trop Dis 8: e3021.
Diro E, Lynen L, Ritmeijer K, Boelaert M, Hailu A, van Griensven J, 2014. Visceral leishmaniasis and HIV coinfection in east Africa. PLoS Negl Trop Dis 8: e2869.
Cota GF, de Sousa MR, Demarqui FN, Rabello A, 2012. The diagnostic accuracy of serologic and molecular methods for detecting visceral leishmaniasis in HIV infected patients: meta-analysis. PLoS Negl Trop Dis 6: e1665.
Pasquau F et al. HIV Mediterreanean Co-operative Group, 2005. Leishmaniasis as an opportunistic infection in HIV-infected patients: determinants of relapse and mortality in a collaborative study of 228 episodes in a Mediterranean region. Eur J Clin Microbiol Infect Dis 24: 411–418.
Cota GF, de Sousa MR, de Mendonça ALP, Patrocinio A, Assunção LS, de Faria SR, Rabello A, 2014. Leishmania-HIV co-infection: clinical presentation and outcomes in an urban area in Brazil. PLoS Negl Trop Dis 8: e2816.
Nascimento ET, Moura MLN, Queiroz JW, Barroso AW, Araujo AF, Rego EF, Wilson ME, Pearson RD, Jeronimo SM, 2011. The emergence of concurrent HIV-1/AIDS and visceral leishmaniasis in northeast Brazil. Trans R Soc Trop Med Hyg 105: 298–300.
Rosenthal E, Marty P, del Giudice P, Pradier C, Ceppi C, Gastaut JA, Le Fichoux Y, Cassuto JP, 2000. HIV and Leishmania coinfection: a review of 91 cases with focus on atypical locations of Leishmania. Clin Infect Dis 31: 1093–1095.
Martins-Melo FR, Lima M da S, Alencar CH, Ramos AN, Heukelbach J, 2014. Epidemiological patterns of mortality due to visceral leishmaniasis and HIV/AIDS co-infection in Brazil, 2000–2011. Trans R Soc Trop Med Hyg 108: 338–347.
Gil-Prieto R, Walter S, Alvar J, de Miguel AG, 2011. Epidemiology of leishmaniasis in Spain based on hospitalization records (1997–2008). Am J Trop Med Hyg 85: 820–825.
De Albuquerque LCP, Mendonça IR, Cardoso PN, Baldaçara LR, Borges MRMM, Borges J da C, Pranchevicius MC da S, 2014. HIV/AIDS-related visceral leishmaniasis: a clinical and epidemiological description of visceral leishmaniasis in northern Brazil. Rev Soc Bras Med Trop 47: 38–46.
Oliveira-Ferreira J, Lacerda MV, Brasil P, Ladislau JL, Tauil PL, Daniel-Ribeiro CT, 2010. Malaria in Brazil: an overview. Malar J 9: 115.
Dias JCP et al. 2016. II Consenso Brasileiro em doença de chagas, 2015. Epidemiol Serv Saude 25: 1–10.
Ibarra-Meneses AV, Ghosh P, Hossain F, Chowdhury R, Mondal D, Alvar J, Moreno J, Carrillo E, 2017. IFN-γ, IL-2, IP-10, and MIG as biomarkers of exposure to Leishmania spp., and of cure in human visceral leishmaniasis. Front Cell Infect Microbiol 7: 200.
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Common in four continents, visceral leishmaniasis (VL) is an important but neglected disease. Human immunodeficiency virus (HIV) infection increases the risk of developing VL in people from leishmaniasis-endemic areas, with worse prognosis when there is coinfection. We conducted a cross-sectional study to determine the prevalence of HIV/VL coinfection in patients admitted in three referral hospitals for HIV/acquired immunodeficiency syndrome (AIDS) in Pernambuco, Brazil, and to compare epidemiological, clinical, and laboratory characteristics among HIV/VL coinfected and HIV mono-infected individuals. The sample consisted of HIV patients aged 18 years or more, in a period of data collection of 6 months. We performed four Leishmania tests—polymerase chain reaction (PCR), direct agglutination test, rK39, and latex agglutination test—and individuals with at least one positive test were considered coinfected. The HIV/VL coinfection prevalence we found was 16.9%. We observed large variation in prevalence according to the Leishmania test used, with low coincidence of positive tests. The most frequent symptoms found were weight loss (75.6%), fever (67.6%), and cough (55.3%). When we compared HIV/VL coinfected and HIV mono-infected groups we did not observe statistically significant differences. Low educational level (P = 0.004) and pallor (P = 0.009) were more frequent in the coinfected group. Serum albumin level was higher in coinfected individuals (P = 0.009). It is important to follow-up these individuals to understand the dynamics of VL in people living with HIV. New tests are necessary, ideally differentiating active from latent infection. Testing for VL in people with HIV is important and should be considered as part of the initial investigation in these individuals.
Financial support: Support was provided by Fundação de Amparo à Ciência e Tecnologia do Estado de Pernambuco (APQ-1284-4.01/08, 0052-4.00/13, and 1712-4.01/15). The authors received partial support from the Conselho Nacional de Desenvolvimento Científico e Tecnológico—CNPq (Scholarship 308590/2013-9 to D. B. M. F., 104573/2014-7 to M. S. S.).
Authors’ addresses: Diego Lins Guedes, Curso de Medicina, Núcleo de Ciências da Vida, Universidade Federal de Pernambuco, Caruaru, Brazil, E-mail: diego.linsguedes@ufpe.br. Zulma Medeiros, Elis Dionísio da Silva, Mariana Santana da Silva, Maria Almerice Lopes da Silva, and Paulo Sérgio Ramos de Araújo, Departamento de Parasitologia, Centro de Pesquisa Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, Brazil, E-mails: medeiros@cpqam.fiocruz.br, dionisio.elis@gmail.com, marianasantanape@gmail.com, almerice@cpqam.fiocruz.br, and psergiora@gmail.com. Audrey Violeta Martins de Vasconcelos, Fundação de Hematologia e Hemoterapia de Pernambuco, Recife, Brazil, E-mail: audrey_marcelino@hotmail.com. Demócrito de Barros Miranda-Filho, Faculdade de Ciências Médicas, Universidade de Pernambuco, Recife, Brazil, E-mail: demofilho@gmail.com.
Desjeux P, Alvar J, 2003. Leishmania/HIV co-infections: epidemiology in Europe. Ann Trop Med Parasitol 97 (Suppl 1): 3–15.
Alvar J, Aparicio P, Aseffa A, Den Boer M, Canavate C, Dedet J-P, Gradoni L, Ter Horst R, Lopez-Velez R, Moreno J, 2008. The relationship between leishmaniasis and AIDS: the second 10 years. Clin Microbiol Rev 21: 334–359.
Alvar J, Vélez ID, Bern C, Herrero M, Desjeux P, Cano J, Jannin J, den Boer M; WHO Leishmaniasis Control Team, 2012. Leishmaniasis worldwide and global estimates of its incidence. PLoS One 7: e35671.
Faucher B, Piarroux R, 2011. Actualités sur les leishmanioses viscérales. Rev Med Interne 32: 544–551.
Okwor I, Uzonna JE, 2013. The immunology of Leishmania/HIV co-infection. Immunol Res 56: 163–171.
Casado JL, Abad-Fernández M, Moreno S, Pérez-Elías MJ, Moreno A, Bernardino JI, Vallejo A, 2015. Visceral leishmaniasis as an independent cause of high immune activation, T-cell senescence, and lack of immune recovery in virologically suppressed HIV-1-coinfected patients. HIV Med 16: 240–248.
Molina R, Gradoni L, Alvar J, 2003. HIV and the transmission of Leishmania. Ann Trop Med Parasitol 97 (Suppl 1): 29–45.
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: 670–673.
Lima IP, Müller MC, Holanda TA, Harhay M, Costa CHN, Costa DL, 2013. Human immunodeficiency virus/Leishmania infantum in the first foci of urban American visceral leishmaniasis: clinical presentation from 1994 to 2010. Rev Soc Bras Med Trop 46: 156–160.
Srivastava P, Dayama A, Mehrotra S, Sundar S, 2011. Diagnosis of visceral leishmaniasis. Trans R Soc Trop Med Hyg 105: 1–6.
Cota GF, de Sousa MR, de Freitas Nogueira BM, Gomes LI, Oliveira E, Assis TSM, de Mendonça ALP, Pinto BF, Saliba JW, Rabello A, 2013. Comparison of parasitological, serological, and molecular tests for visceral leishmaniasis in HIV-infected patients: a cross-sectional delayed-type study. Am J Trop Med Hyg 89: 570–577.
El Harith A, Kolk AHJ, Leewenburg J, Muigai R, Huigen E, Jelsma T, Kager P, 1988. Improvement of a direct agglutination test for field studies of visceral leishmaniasis. J Clin Microbiol 26: 1321–1325.
Schönian G, Nasereddin A, Dinse N, Schweynoch C, Schallig HDF, Presber W, Jaffe CL, 2003. PCR diagnosis and characterization of Leishmania in local and imported clinical samples. Diagn Microbiol Infect Dis 47: 349–358.
Carranza-Tamayo CO, de Assis TSM, Neri ATB, Cupolillo E, Rabello A, Romero GAS, 2009. Prevalence of Leishmania infection in adult HIV/AIDS patients treated in a tertiary-level care center in Brasilia, Federal District, Brazil. Trans R Soc Trop Med Hyg 103: 743–748.
Orsini M, Canela JR, Disch J, Maciel F, Greco D, Toledo A, Rabello A, 2012. High frequency of asymptomatic Leishmania spp. infection among HIV-infected patients living in endemic areas for visceral leishmaniasis in Brazil. Trans R Soc Trop Med Hyg 106: 283–288.
Monge-Maillo B, Norman FF, Cruz I, Alvar J, López-Vélez R, 2014. Visceral leishmaniasis and HIV coinfection in the mediterranean region. PLoS Negl Trop Dis 8: e3021.
Diro E, Lynen L, Ritmeijer K, Boelaert M, Hailu A, van Griensven J, 2014. Visceral leishmaniasis and HIV coinfection in east Africa. PLoS Negl Trop Dis 8: e2869.
Cota GF, de Sousa MR, Demarqui FN, Rabello A, 2012. The diagnostic accuracy of serologic and molecular methods for detecting visceral leishmaniasis in HIV infected patients: meta-analysis. PLoS Negl Trop Dis 6: e1665.
Pasquau F et al. HIV Mediterreanean Co-operative Group, 2005. Leishmaniasis as an opportunistic infection in HIV-infected patients: determinants of relapse and mortality in a collaborative study of 228 episodes in a Mediterranean region. Eur J Clin Microbiol Infect Dis 24: 411–418.
Cota GF, de Sousa MR, de Mendonça ALP, Patrocinio A, Assunção LS, de Faria SR, Rabello A, 2014. Leishmania-HIV co-infection: clinical presentation and outcomes in an urban area in Brazil. PLoS Negl Trop Dis 8: e2816.
Nascimento ET, Moura MLN, Queiroz JW, Barroso AW, Araujo AF, Rego EF, Wilson ME, Pearson RD, Jeronimo SM, 2011. The emergence of concurrent HIV-1/AIDS and visceral leishmaniasis in northeast Brazil. Trans R Soc Trop Med Hyg 105: 298–300.
Rosenthal E, Marty P, del Giudice P, Pradier C, Ceppi C, Gastaut JA, Le Fichoux Y, Cassuto JP, 2000. HIV and Leishmania coinfection: a review of 91 cases with focus on atypical locations of Leishmania. Clin Infect Dis 31: 1093–1095.
Martins-Melo FR, Lima M da S, Alencar CH, Ramos AN, Heukelbach J, 2014. Epidemiological patterns of mortality due to visceral leishmaniasis and HIV/AIDS co-infection in Brazil, 2000–2011. Trans R Soc Trop Med Hyg 108: 338–347.
Gil-Prieto R, Walter S, Alvar J, de Miguel AG, 2011. Epidemiology of leishmaniasis in Spain based on hospitalization records (1997–2008). Am J Trop Med Hyg 85: 820–825.
De Albuquerque LCP, Mendonça IR, Cardoso PN, Baldaçara LR, Borges MRMM, Borges J da C, Pranchevicius MC da S, 2014. HIV/AIDS-related visceral leishmaniasis: a clinical and epidemiological description of visceral leishmaniasis in northern Brazil. Rev Soc Bras Med Trop 47: 38–46.
Oliveira-Ferreira J, Lacerda MV, Brasil P, Ladislau JL, Tauil PL, Daniel-Ribeiro CT, 2010. Malaria in Brazil: an overview. Malar J 9: 115.
Dias JCP et al. 2016. II Consenso Brasileiro em doença de chagas, 2015. Epidemiol Serv Saude 25: 1–10.
Ibarra-Meneses AV, Ghosh P, Hossain F, Chowdhury R, Mondal D, Alvar J, Moreno J, Carrillo E, 2017. IFN-γ, IL-2, IP-10, and MIG as biomarkers of exposure to Leishmania spp., and of cure in human visceral leishmaniasis. Front Cell Infect Microbiol 7: 200.
Past two years | Past Year | Past 30 Days | |
---|---|---|---|
Abstract Views | 688 | 537 | 133 |
Full Text Views | 754 | 14 | 8 |
PDF Downloads | 309 | 12 | 4 |