皮肤利什曼病患者利什曼原虫中利什曼 RNA 病毒的流行率：系统评价和荟萃分析。

BACKGROUND: Cutaneous leishmaniasis is caused by different protozoan parasites of the genus Leishmania. Leishmania RNA virus (LRV) was identified as the first Leishmania infecting virus in 1998. Different studies showed the presence and role of the LRV in Leishmania parasites causing cutaneous leishmaniasis (CL). However, there is limited data on the pooled prevalence of LRV in Leishmania parasites causing CL. Therefore, the aim of this systematic review and meta-analysis was to determine the pooled prevalence of LRV in Leishmania parasite isolates and/or lesion biopsies in patients with CL from the available literature globally. METHODOLOGY: We retrieved the studies from different electronic databases. The studies were screened and identified based on the inclusion and exclusion criteria. We excluded studies exclusively done in experimental animals and in vitro studies. The review was conducted in line with PRISMA guidelines. The meta-analysis was performed with Stata software version 14 with metan command. The forest plot with random-effect model was used to estimate the pooled prevalence with 95% confidence interval. Inverse variance index (I2) was used to assess the heterogeneity among the included articles. PRINCIPAL FINDINGS: A total of 1215 samples from 25 studies were included. Of these, 40.1% (487/1215) were positive for LRV. The overall pooled prevalence of LRV globally was 37.22% (95% CI: 27.54% - 46.90%). The pooled prevalence of LRV in the New World (NW) and Old World (OW) regions was 34.18% and 45.77%, respectively. Leishmania guyanensis, L. braziliensis, L. major, and L. tropica were the most studied species for the detection of LRV. The prevalence of LRV from Leishmania isolates and lesion biopsies was 42.9% (349/813) and 34.3% (138/402), respectively. CONCLUSION: This systematic study revealed that there is high prevalence of LRV in Leishmania parasites isolated from patients with CL. More comprehensive studies would be required to investigate the presence of the LRV in other Leishmania species such as L. aethiopica to fully understand the role of LRV in different clinical manifestations and disease pathology presented in CL patients.

背景：皮肤利什曼病是由不同种利什曼原虫属的原生动物寄生虫引起的。1998 年，利什曼 RNA 病毒（LRV）被确定为第一种感染利什曼原虫的病毒。不同的研究表明，LRV 存在于引起皮肤利什曼病（CL）的利什曼寄生虫中，并发挥作用。然而，关于引起 CL 的利什曼寄生虫中 LRV 的总流行率的数据有限。因此，本系统评价和荟萃分析的目的是确定全球现有文献中从 CL 患者的利什曼寄生虫分离物和/或病变活检中检测到的 LRV 的总流行率。

方法：我们从不同的电子数据库中检索了这些研究。根据纳入和排除标准筛选和确定研究。我们排除了仅在实验动物中进行的研究和体外研究。该综述符合 PRISMA 指南进行。使用 Stata 软件版本 14 中的 metan 命令进行荟萃分析。使用随机效应模型的森林图来估计合并的流行率和 95%置信区间。使用逆方差指数（I2）来评估纳入文章之间的异质性。

主要发现：共有 25 项研究的 1215 个样本纳入分析。其中，40.1%（487/1215）为 LRV 阳性。全球 LRV 的总流行率为 37.22%（95%CI：27.54% - 46.90%）。新世界（NW）和旧世界（OW）地区的 LRV 总流行率分别为 34.18%和 45.77%。利什曼原虫圭亚那、L. braziliensis、L. major 和 L. tropica 是检测 LRV 的最常见物种。从利什曼寄生虫分离物和病变活检中检测到的 LRV 流行率分别为 42.9%（349/813）和 34.3%（138/402）。

结论：本系统研究表明，从 CL 患者中分离的利什曼寄生虫中 LRV 的流行率很高。需要进行更全面的研究，以调查其他利什曼物种（如 L. aethiopica）中 LRV 的存在，以充分了解 LRV 在 CL 患者不同临床表现和疾病病理学中的作用。