da Silva Elis D, de Oliveira Beatriz C, Pereira Allana M de S, Guedes Diego L, de Melo Neto Osvaldo P, Costa Carlos H N, de Medeiros Zulma M, Pereira Valéria R A
Aggeu Magalhães Institute, Oswaldo Cruz Foundation, Recife, Brazil.
Laboratory of Leishmaniasis, Natan Portella Institute of Tropical Medicine, Teresina, Brazil.
Front Med (Lausanne). 2021 Apr 30;8:553280. doi: 10.3389/fmed.2021.553280. eCollection 2021.
Visceral Leishmaniasis (VL) is a severe parasitic disease that has emerged as an important opportunistic condition in HIV-infected patients and whose control is impaired by inaccurate identification. This is mainly due to the serological tests used for VL having a reduced performance in cases of VL-HIV coinfection due to a low humoral response. In this situation, however, a positive test has even greater diagnostic value when combined with the clinical status. This study aimed to evaluate the application and performance of flow cytometry to detect anti- antibodies in HIV-infected patients. Sera from VL/HIV coinfected patients, characterized using "gold standard" techniques, were compared with sera from healthy controls plus sera from HIV-infected individuals. The flow cytometry results were expressed as levels of IgG reactivity, based on the percentage of positive fluorescent parasites (PPFP). A ROC curve analysis of a serum titration indicated a PPFP of 1.26% as being the cutoff point to segregate positive and negative results. At the 1:2,048 dilution, with 89% sensitivity and 83% specificity, flow cytometry showed greater sensitivity in relation to the serological tests evaluated. Futhermore, flow cytometry was the only assay that positively identified all VL-HIV patients with quantified HIV load. Together, these findings suggest that flow cytometry may be used as an alternative serological approach for VL identification and as a tool to characterize the humoral response against in HIV-infected patients.
内脏利什曼病(VL)是一种严重的寄生虫病,已成为HIV感染患者重要的机会性疾病,其控制因识别不准确而受到影响。这主要是由于用于VL的血清学检测在VL-HIV合并感染病例中因体液反应低而性能降低。然而,在这种情况下,阳性检测结果与临床状况相结合时具有更大的诊断价值。本研究旨在评估流式细胞术在检测HIV感染患者抗抗体方面的应用和性能。将使用“金标准”技术鉴定的VL/HIV合并感染患者的血清与健康对照血清以及HIV感染个体的血清进行比较。流式细胞术结果以IgG反应性水平表示,基于阳性荧光寄生虫百分比(PPFP)。血清滴定的ROC曲线分析表明,PPFP为1.26%是区分阳性和阴性结果的临界点。在1:2048稀释度下,流式细胞术的灵敏度为89%,特异性为83%,与所评估的血清学检测相比,显示出更高的灵敏度。此外,流式细胞术是唯一能对所有HIV载量定量的VL-HIV患者进行阳性鉴定的检测方法。总之,这些发现表明,流式细胞术可作为VL鉴定的替代血清学方法,并作为表征HIV感染患者针对利什曼原虫体液反应的工具。
Front Med (Lausanne). 2021-4-30
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