Department of Infectious Diseases, Federal University of Rio Grande do Norte, Rua Cônego Monte, 110, Quintas, Natal/RN, Rio Grande do Norte, 59037-170, Brazil.
Department of Infectious and Parasitic Diseases, University of São Paulo Medical School, Sao Paulo, Sao Paulo, Brazil.
BMC Infect Dis. 2020 Nov 25;20(1):885. doi: 10.1186/s12879-020-05622-2.
There is little information about the frequency of Leishmania infection in asymptomatic people living with HIV (PLWH) and about the performance of laboratory diagnostic methods in coinfected patients in Latin America. The main objective of this study is to evaluate the frequency of Leishmania spp. infection in HIV-infected patients living in an urban area in Brazil.
To detect Leishmania infection, diagnostic tests were performed to detect anti-Leishmania antibodies (ELISA using Leptomonas seymouri antigens; ELISA using rK39 antigens; ELISA using rK28 antigens; indirect fluorescent-antibody test (IFAT); direct agglutination test (DAT)) and Leishmania DNA (polymerase chain reaction (PCR) with the target genes kDNA and ITS-1).
The frequency of at least one positive test was 15%. For ELISA using Leptomonas antigens and IFAT, there was an association between CD4+ T lymphocyte counts and test positivity, with a higher positivity of these tests in more immunosuppressed patients (CD4+ T cell count < 200/mm).
According to our data, there was a high prevalence of Leishmania spp. infections in this population living with HIV. Although there is the possibility of cross-reaction, some tests that are considered highly specific for the diagnosis of Leishmania infection were positive. There was also an association between the positivity of some tests studied and lower values of CD4+ T lymphocytes.
关于无症状 HIV 感染者（PLWH）中利什曼原虫感染的频率以及在合并感染的患者中实验室诊断方法的性能，信息很少。本研究的主要目的是评估巴西一个城市地区 HIV 感染患者中利什曼原虫属感染的频率。
为了检测利什曼原虫感染，进行了诊断检测以检测抗利什曼原虫抗体（使用 Leptomonas seymouri 抗原的 ELISA；使用 rK39 抗原的 ELISA；使用 rK28 抗原的 ELISA；间接荧光抗体试验（IFAT）；直接凝集试验（DAT））和利什曼原虫 DNA（聚合酶链反应（PCR）与 kDNA 和 ITS-1 靶基因）。
至少有一种阳性检测结果的频率为 15%。对于使用 Leptomonas 抗原的 ELISA 和 IFAT，CD4+T 淋巴细胞计数与检测阳性之间存在关联，在免疫抑制程度更高的患者（CD4+T 细胞计数<200/mm）中，这些检测的阳性率更高。
根据我们的数据，该 HIV 感染者群体中存在利什曼原虫属感染的高流行率。尽管存在交叉反应的可能性，但一些被认为对利什曼原虫感染诊断高度特异的检测呈阳性。一些研究的检测阳性率与 CD4+T 淋巴细胞计数较低之间也存在关联。
