Dipartimento di Scienze per la Promozione della Salute, Sezione di Malattie Infettive, Università di Palermo, Palermo, Italy.
BMC Infect Dis. 2009 Dec 10;9:199. doi: 10.1186/1471-2334-9-199.
Visceral leishmaniasis (VL) is a protozoan diseases caused in Europe by Leishmania (L.) infantum. Asymptomatic Leishmania infection is more frequent than clinically apparent disease. Among HIV infected patients the risk of clinical VL is increased due to immunosuppression, which can reactivate a latent infection. The aims of our study were to assess the prevalence of asymptomatic L. infantum infection in HIV infected patients and to study a possible correlation between Leishmania parasitemia and HIV infection markers.
One hundred and forty-five HIV infected patients were screened for the presence of anti-Leishmania antibodies and L. infantum DNA in peripheral blood. Statistical analysis was carried out by using a univariate regression analysis.
Antibodies to L. infantum were detected in 1.4% of patients. L. infantum DNA was detected in 16.5% of patients. Significant association for PCR-Leishmania levels with plasma viral load was documented (p = 0.0001).
In our area a considerable proportion of HIV infected patients are asymptomatic carriers of L. infantum infection. A relationship between high HIV viral load and high parasitemic burden, possibly related to a higher risk of developing symptomatic disease, is suggested. PCR could be used for periodic screening of HIV patients to individuate those with higher risk of reactivation of L. infantum infection.
内脏利什曼病（VL）是一种由利什曼原虫（L.）引起的原生动物疾病，在欧洲发生。无症状利什曼原虫感染比临床显性疾病更为常见。在 HIV 感染患者中，由于免疫抑制，临床 VL 的风险增加，这可能会使潜伏感染重新激活。我们的研究目的是评估 HIV 感染患者中无症状 L. infantum 感染的流行率，并研究利什曼原虫寄生虫血症与 HIV 感染标志物之间的可能相关性。
对 145 名 HIV 感染患者进行了筛查，以检测外周血中是否存在抗利什曼原虫抗体和 L. infantum DNA。采用单变量回归分析进行统计分析。
1.4%的患者检测出抗 L. infantum 抗体。16.5%的患者检测出 L. infantum DNA。PCR-利什曼原虫水平与血浆病毒载量之间存在显著相关性（p=0.0001）。
在我们的地区，相当一部分 HIV 感染患者是无症状的 L. infantum 感染携带者。提示 HIV 病毒载量高与寄生虫负荷高之间存在关系，这可能与发生症状性疾病的风险增加有关。PCR 可用于定期筛查 HIV 患者，以确定那些具有更高利什曼原虫感染再激活风险的患者。
