Fundação Educacional de Andradina, São Paulo, Andradina, Brazil.
Departamento de Assuntos Regulatórios e Desenvolvimento da Virbac Brasil, São Paulo, Brazil.
Parasit Vectors. 2019 Feb 8;12(1):79. doi: 10.1186/s13071-019-3323-0.
Visceral leishmaniasis (VL) is an infectious disease with a variety of clinical signs. The main form of parasite transmission to humans and other mammalian hosts is through the bite of infected arthropod females with Lutzomyia longipalpis serving as the main vector in the Americas. Dogs are the main urban domestic reservoirs of the parasite and the main source of vector infection due to their high prevalence in endemic areas and the large number of parasites in the skin of infected animals. Although miltefosine has been used in Europe since 2002 for treatment of VL infected dogs, in the Americas the treatment of dogs has not been recommended. Therefore, this study aimed to evaluate efficacy of miltefosine observing a reduction of clinical signs in infected dogs and the infectiveness to the vector by Leishmania (L.) infantum.
To our knowledge, this is the first controlled study using qPCR and xenodiagnosis to evaluate the efficacy of miltefosine (Milteforan®, Virbac) as a single treatment in Brazil. Thirty-five adult dogs with canine visceral leishmaniasis (CVL), confirmed by clinical and laboratory tests, were included in this study. They received miltefosine at a dose of 2 mg/kg every 24 h for 28 days. The dogs were observed over a three-month period, during which clinical evaluations based on a scoring system were conducted at pre-established times. Parasite load was assessed by cytology and real-time polymerase chain reaction (qPCR). Transmissibility to the vector was evaluated by xenodiagnosis.
At the end of the period, the following were observed: (i) the remission of clinical signs with a reduction in clinical scores for 94.2% of the animals; (ii) a statistically significant reduction (98.7%) in parasitic load by qPCR; and (iii) a reduction in infectivity to sand flies. After treatment, 74.2% of the animals remained or had become non-infectious.
Our study indicates that the use of miltefosine administered orally for 4 weeks contributes to a clinical improvement and reduction in infectivity of dogs to L. infantum.
内脏利什曼病（VL）是一种具有多种临床体征的传染病。寄生虫主要通过受感染的节肢动物雌性叮咬向人类和其他哺乳动物宿主传播，在美洲，长角血蜱（Lutzomyia longipalpis）是主要的传播媒介。狗是寄生虫的主要城市家养宿主，也是媒介感染的主要来源，因为它们在流行地区的高患病率和受感染动物皮肤中的大量寄生虫。尽管米替福新自 2002 年以来在欧洲用于治疗感染 VL 的狗，但在美洲，不建议对狗进行治疗。因此，本研究旨在评估米替福新的疗效，观察受感染的狗的临床体征减少和利什曼原虫（L.）感染媒介的感染性。婴儿。
据我们所知，这是在巴西首次使用 qPCR 和异种诊断评估米替福新（Milteforan®，Virbac）作为单一治疗犬内脏利什曼病（CVL）的疗效的对照研究。35 只成年犬患有犬内脏利什曼病（CVL），通过临床和实验室检查证实，接受米替福新治疗，剂量为 2 毫克/千克，每 24 小时一次，持续 28 天。在三个月的观察期内，根据预先设定的时间进行临床评分的临床评估。通过细胞学和实时聚合酶链反应（qPCR）评估寄生虫负荷。通过异种诊断评估对媒介的传播能力。
在研究结束时，观察到以下结果：（i）94.2%的动物临床症状缓解，临床评分降低；（ii）qPCR 检测寄生虫负荷显著降低（98.7%）；（iii）对沙蝇的感染力降低。治疗后，74.2%的动物仍具有或已成为非传染性的。
我们的研究表明，口服米替福新治疗 4 周有助于改善临床症状并降低犬对 L. 婴儿的感染力。infantum。
