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Journal of Clinical Microbiology, January 2001, p. 357-361, Vol. 39, No. 1
Institute of Infectious Diseases and Tropical
Medicine, University of Milan,1 2nd
Division of Infectious Diseases,2 and
1st Division of Infectious Diseases,3 L. Sacco Hospital Institute of Infectious Diseases, University of
Modena,4 and San Luigi Center for
Infectious Diseases, San Raffaele Hospital,5
Milan, Department of Parasitology, Istituto Superiore di
Sanità, Rome,6 and Institute of
Infectious Pathology and Virology, University of Palermo,
Palermo,7 Italy
Received 15 May 2000/Returned for modification 27 July
2000/Accepted 18 October 2000
A group of 76 consecutive human immunodeficiency virus
(HIV)-positive patients with fever of unknown origin
(n = 52) or fever associated with pulmonary diseases
was evaluated in order to assess the usefulness of PCR with peripheral
blood in the diagnosis and follow-up of visceral leishmaniasis. We
identified 10 cases of visceral leishmaniasis among the 52 patients
with fever of unknown origin. At the time of diagnosis, all were
parasitemic by PCR with peripheral blood. During follow-up, a
progressive decline in parasitemia was observed under therapy, and all
patients became PCR negative after a median of 5 weeks (range, 6 to 21 weeks). However, in eight of nine patients monitored for a
median period of 88 weeks (range, 33 to 110 weeks), visceral
leishmaniasis relapsed, with positive results by PCR with peripheral
blood reappearing 1 to 2 weeks before the clinical onset of disease.
Eight Leishmania infantum and two Leishmania
donovani infections were identified by PCR-restriction fragment
length polymorphism analysis. PCR with peripheral blood is a reliable
method for diagnosis of visceral leishmaniasis in HIV-infected
patients. During follow-up, it substantially reduces the need for
traditional invasive tests to assess parasitological response, while a
positive PCR result is predictive of clinical relapse.
0095-1137/01/$04.00+0 DOI: 10.1128/JCM.39.1.357-361.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.
Role of PCR in Diagnosis and Prognosis of Visceral Leishmaniasis
in Patients Coinfected with Human Immunodeficiency Virus Type
1
*
Corresponding author. Mailing address: Institute of
Infectious Diseases and Tropical Medicine, University of Milan L. Sacco Hospital, Via GB Grassi 74, 20157 Milan, Italy. Phone: 39 02 3567031. Fax: 39 02 3560805. E-mail: spantin{at}tin.it.
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