在合并感染艾滋病毒的患者中，复发性内脏利什曼病复发的特点是免疫反应效率较低且寄生虫负荷较高。

Recurrent visceral leishmaniasis relapses in HIV co-infected patients are characterized by less efficient immune responses and higher parasite load.

作者信息

Takele Yegnasew, Mulaw Tadele, Adem Emebet, Womersley Rebecca, Kaforou Myrsini, Franssen Susanne Ursula, Levin Michael, Taylor Graham Philip, Müller Ingrid, Cotton James Anthony, Kropf Pascale

机构信息

Department of Infectious Disease, Imperial College London, London, UK.

Leishmaniasis Research and Treatment Centre, University of Gondar, Gondar, Ethiopia.

出版信息

iScience. 2022 Dec 23;26(2):105867. doi: 10.1016/j.isci.2022.105867. eCollection 2023 Feb 17.

DOI:10.1016/j.isci.2022.105867

PMID:36685039

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9845767/

Abstract

Visceral leishmaniasis (VL) and HIV co-infection (VL/HIV) has emerged as a significant public health problem in Ethiopia, with up to 30% of patients with VL co-infected with HIV. These patients suffer from recurrent VL relapses and increased mortality. Those with a previous history of VL relapses (recurrent VL/HIV) experience increased VL relapses as compared to patients with HIV presenting with their first episode of VL (primary VL/HIV). Our aim was to identify drivers that account for the higher rate of VL relapses in patients with recurrent VL/HIV (n = 28) as compared to primary VL/HIV (n = 21). Our results show that the relapse-free survival in patients with recurrent VL/HIV was shorter, that they had higher parasite load, lower weight gain, and lower recovery of all blood cell lineages. Their poorer prognosis was characterized by lower production of IFN-gamma, lower CD4 T cell counts, and higher expression of programmed cell death protein 1 (PD1) on T cells.

摘要

内脏利什曼病（VL）与人类免疫缺陷病毒（HIV）合并感染（VL/HIV）已成为埃塞俄比亚一个重大的公共卫生问题，高达30%的VL患者合并感染HIV。这些患者遭受VL反复发作且死亡率增加。与首次出现VL的HIV患者（原发性VL/HIV）相比，既往有VL复发史的患者（复发性VL/HIV）VL复发增加。我们的目的是确定与原发性VL/HIV（n = 21）相比，导致复发性VL/HIV患者（n = 28）VL复发率更高的驱动因素。我们的结果表明，复发性VL/HIV患者的无复发生存期较短，寄生虫载量较高，体重增加较少，所有血细胞谱系的恢复较低。其较差的预后表现为干扰素-γ产生较低、CD4 T细胞计数较低以及T细胞上程序性细胞死亡蛋白1（PD1）表达较高。