Alborzi Abdolvahab, Pourabbas Bahman, Shahian Frahad, Mardaneh Jalal, Pouladfar Gholam R, Ziyaeyan Mazyar
Professor Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Am J Trop Med Hyg. 2008 Dec;79(6):839-42.
Visceral leishmaniasis (VL), caused by Leishmania infantum, is endemic in southern Iran. To detect asymptomatic individuals, we used kinetoplast DNA (kDNA) polymerase chain reaction (PCR)-ELISA methods on 388 blood samples of healthy persons in two endemic loci and compared the results with the leishmanin skin test (LST) and the immunofluorescent antibody test (IFAT). kDNA PCR, LST, and IFAT were positive in 95 (24.5%), 132 (34%), and 212 (54.6%) cases, respectively. Fifty-five (21.4%) individuals that were LST negative were PCR positive. All PCR-positive individuals had a titer of >or=1:20, whereas 45% of those that were IFAT positive were PCR positive. For a reliable index of prevalence rate of infection, LST alone is not sufficient and needs to be accompanied by PCR-ELISA. The high rate of kDNA-positive results may indicate the possibility of humans being a reservoir and source of transmission. In endemic areas, kDNA PCR-ELISA is not a reliable test for the diagnosis of active VL.
由婴儿利什曼原虫引起的内脏利什曼病（VL）在伊朗南部呈地方性流行。为了检测无症状个体，我们在两个流行地区对388份健康人血液样本采用动基体DNA（kDNA）聚合酶链反应（PCR）-酶联免疫吸附测定（ELISA）方法，并将结果与利什曼原虫素皮肤试验（LST）和免疫荧光抗体试验（IFAT）进行比较。kDNA PCR、LST和IFAT检测阳性的病例分别为95例（24.5%）、132例（34%）和212例（54.6%）。55例（21.4%）LST阴性个体PCR检测呈阳性。所有PCR阳性个体的滴度均≥1:20，而IFAT阳性个体中有45%的人PCR检测呈阳性。对于可靠的感染患病率指标而言，仅靠LST是不够的，还需要结合PCR-ELISA。kDNA阳性结果的高比例可能表明人类作为储存宿主和传播源的可能性。在流行地区，kDNA PCR-ELISA并非诊断活动性VL的可靠检测方法。
