Otero A C, da Silva V O, Luz K G, Palatnik M, Pirmez C, Fernandes O, Palatnik de Sousa C B
Instituto de Microbiologia Professor Paulo de Góes and Hospital Universitário-Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
Am J Trop Med Hyg. 2000 Jan;62(1):128-31. doi: 10.4269/ajtmh.2000.62.128.
Human visceral leishmaniasis (kala-azar) transmitted by blood transfusion has been described in previous reports. Seroprevalence of antibodies to Leishmania donovani was shown to be related to prior blood transfusions in multiply transfused hemodialysis patients in Natal, Rio Grande do Norte, Brazil. In this study, a possible correlation between seroreactivity and the presence of L. donovani DNA was investigated in asymptomatic healthy blood donors. Sera were tested using the fucose mannose ligand (FML) ELISA, which was shown to have a sensitivity of 100%, a specificity of 96-100%, reliability, and diagnostic and prognostic potential for the detection of human and canine kala-azar, respectively. Leishmanial DNA was assessed by the polymerase chain reaction (PCR) and dot-blot hybridization techniques in blood and bone marrow samples. Among 21 FML-seroreactive asymptomatic blood donors, 5 (24%) were positive by the PCR and 9 (43%) were positive in a dot-blot assay of blood samples, showing a significant correlation (chi2 = 14.24, P < 0.01). No Leishmania DNA was detected in 20 FML non-reactive blood donors. Our results point to the need for control of transmission of kala-azar by blood transfusion in areas endemic for this disease.
先前的报告中已描述过通过输血传播的人类内脏利什曼病（黑热病）。在巴西北里奥格兰德州纳塔尔接受多次输血的血液透析患者中，杜氏利什曼原虫抗体的血清阳性率显示与既往输血有关。在本研究中，对无症状健康献血者的血清反应性与杜氏利什曼原虫DNA的存在之间的可能相关性进行了调查。使用岩藻糖甘露糖配体（FML）ELISA检测血清，该方法对检测人类和犬类黑热病的敏感性为100%，特异性为96%-100%，具有可靠性以及诊断和预后潜力。通过聚合酶链反应（PCR）和斑点杂交技术评估血液和骨髓样本中的利什曼原虫DNA。在21名FML血清反应阳性的无症状献血者中，5名（24%）PCR检测呈阳性，9名（43%）血液样本斑点杂交检测呈阳性，显示出显著相关性（χ2 = 14.24，P < 0.01）。在20名FML血清反应阴性的献血者中未检测到利什曼原虫DNA。我们的结果表明，在这种疾病的流行地区，需要控制通过输血传播黑热病。
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