Mathur Purva, Samantaray J C, Vajpayee Madhu, Samanta Palash
Division of Parasitology and HIV/Immunology, Department of Microbiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi - 110029, India.
J Med Microbiol. 2006 Jul;55(Pt 7):919-922. doi: 10.1099/jmm.0.46574-0.
India contributes heavily to the global burden of visceral leishmaniasis (VL, kala-azar) and human immunodeficiency virus (HIV)/AIDS. The prevalence of HIV seropositivity in VL patients at a tertiary care centre in northern India, as observed during a prospective study over a period of 2 years, is presented. Of the 104 cases of VL/post-kala-azar dermal leishmaniasis, six (5.7 %) were found to be HIV positive, compared to 11 (5.5 %) seropositive for HIV of 198 patients with fever due to other causes. Four of the six (67 %) VL/HIV co-infected patients had a chronic/relapsing course, not responding to antileishmanial treatment. A CD4 T-cell count of < 200 mm(-3) was found in four of the five (80 %) co-infected patients in whom the test was done. Although the level of HIV/VL co-infection in the present study was lower than that of Mediterranean countries, there is a trend towards rising co-infection. The VL-endemic states of India have a huge population of migrant labourers, who work in high-HIV-prevalence states. The reported increase in the prevalence of HIV in the VL-endemic, populous states of India is a cause of grave concern, and co-infection may assume epidemic proportions in the coming decade if left unchecked.
印度在全球内脏利什曼病（VL，黑热病）和人类免疫缺陷病毒（HIV）/艾滋病负担中占很大比例。本文呈现了在印度北部一家三级医疗中心进行的为期2年的前瞻性研究中观察到的VL患者的HIV血清阳性率。在104例VL/黑热病后皮肤利什曼病病例中，有6例（5.7%）被发现HIV呈阳性，相比之下，198例因其他原因发热的患者中有11例（5.5%）HIV血清呈阳性。6例VL/HIV合并感染患者中有4例（67%）病程呈慢性/复发型，对抗利什曼原虫治疗无反应。在进行检测的5例合并感染患者中，有4例（80%）的CD4 T细胞计数<200/mm³。尽管本研究中HIV/VL合并感染水平低于地中海国家，但合并感染有上升趋势。印度VL流行地区有大量流动劳工，他们在HIV高流行地区工作。据报道，印度VL流行且人口众多的邦中HIV患病率上升，这令人严重关切，如果不加以控制，合并感染在未来十年可能会呈流行态势。
