Campelo Cássio Marinho, Medvedovsky Andres Christopher, de Holanda Pablo Eliak Linhares, de Oliveira Denis Francisco Gonçalves, de Albuquerque-Pinto Luiz Carlos, Melo Luciana Magalhães, Câmara Lilia Maria Carneiro
Department of Pathology and Legal Medicine, Biomedicine Center, Federal University of Ceará/Brazil, Coronel Nunes de Melo Street 1312, Rodolfo Teófilo, Fortaleza, Ceará 60430-270 Brazil.
TEFL Academy, London, England.
Indian J Microbiol. 2024 Jun;64(2):511-519. doi: 10.1007/s12088-023-01182-6. Epub 2024 Jan 27.
Visceral leishmaniasis (VL) occurs due to the evolution, virulence, and adaptation of , vector biology, host immune system evasion, and reservoir hosts. Parasitemia can be involved as a warning regarding the clinical severity of VL The present study aims to evaluate the relationship between parasitemia and the prognosis of individuals with VL. Blood and bone marrow samples from individuals with VL were analyzed to identify parasite and quantify or measure parasite burden. Individuals were classified in the clinical score model of risk of death by disease proposed by Coura-Vital et al. (PLoS Negl Trop Dis 8(12): e33742014, 2014). 39/74 individuals presented a better prognosis, and 35/74 individuals presented a worse prognosis. HIV + VL co-infection was present in 32 individuals, of which 12 were considered severe. The group aged 51 to 64 was classified as severe, with a decrease in leukocytes (-value 0.0295) and neutrophils (-value 0.0476). DNA was identified in blood and bone marrow, in 69 individuals, and not detected in 5 individuals. The quantification of the parasite showed greater parasitemia in bone marrow ( = 0.0003) with an average of 4.70 × 10 /mL about blood, with 0.29 × 10 /mL. Individuals in the age group aged 51 to 64 co-infected with HIV + VL had higher parasitemia (-value 0.0150) with 2.44 × 10 /mL in blood and bone marrow than in the group aged 20 to 50. Parasitemia, measured by molecular biology in blood and bone marrow, was related to the worst clinical prognosis of VL in the age group aged 51 to 64.
内脏利什曼病（VL）的发生是由于病原体的进化、毒力、适应性、媒介生物学、宿主免疫系统逃避以及储存宿主等因素。寄生虫血症可能与VL的临床严重程度有关。本研究旨在评估寄生虫血症与VL患者预后之间的关系。对VL患者的血液和骨髓样本进行分析，以鉴定寄生虫并量化或测量寄生虫负荷。根据Coura-Vital等人（《公共科学图书馆·被忽视的热带病》8(12): e3374，2014年）提出的疾病死亡风险临床评分模型对个体进行分类。74名个体中，39名预后较好，35名预后较差。32名个体存在HIV+VL合并感染，其中12名被认为病情严重。51至64岁年龄组被归类为严重，白细胞（-值0.0295）和中性粒细胞（-值0.0476）减少。在69名个体的血液和骨髓中检测到DNA，5名个体未检测到。寄生虫定量显示骨髓中的寄生虫血症更高（=0.0003），血液中的平均寄生虫血症为4.70×10/mL，而血液中的为0.29×10/mL。5至64岁年龄组合并HIV+VL感染的个体，其血液和骨髓中的寄生虫血症更高（-值0.0150），为2.44×10/mL，高于20至50岁年龄组。通过分子生物学方法在血液和骨髓中测量的寄生虫血症与51至64岁年龄组VL的最差临床预后相关。
