This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Copyright Information Books from ASM Press MicrobeWorld Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Maurya, R. Articles by Sundar, S. Search for Related Content PubMed PubMed Citation Articles by Maurya, R. Articles by Sundar, S.

Evaluation of PCR for Diagnosis of Indian Kala-Azar and Assessment of Cure

Infectious Diseases Research Laboratory, Department of Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221 005,¹ Institute of Pathology, New Delhi, India²

Received 20 October 2004/ Returned for modification 6 December 2004/ Accepted 12 February 2005

This study was done to evaluate PCR with Ld1 primers for the diagnosis of Indian visceral leishmaniasis (VL) and to assess its role in prediction of the disease outcome. The PCR assay was performed with DNA isolated from the peripheral blood of parasitologically confirmed cases of VL before the initiation of treatment, just after the end of treatment, and at 3 and 6 months of follow-up. The pretreatment PCR result was positive for 100 of 101 patients (sensitivity, 99%; confidence interval [CI], 94 to 100%). None of the 150 negative controls tested were PCR positive (specificity, 100%; CI, 96.8 to 100%). Of 60 patients who were treated at our center, 51 (85%; CI, 73 to 93%) became negative immediately after treatment and continued to be negative at 3 and 6 months of follow-up. At the 3-month follow-up, two of the remaining nine patients were PCR positive, making 58 (96.7%; CI, 87 to 100%) patients PCR negative. At the 6-month follow-up, all patients became PCR negative. One patient who was PCR negative immediately after the end of treatment relapsed 11 months later. This limited prospective study with VL patients suggests that the PCR assay is a highly sensitive and specific (99% and 100%, respectively) tool for the diagnosis of VL. In the majority of patients, it can identify a successful disease outcome; however, its translation into the field setting remains a major challenge.

This article has been cited by other articles:

• Reithinger, R., Dujardin, J.-C. (2007). Molecular Diagnosis of Leishmaniasis: Current Status and Future Applications. J. Clin. Microbiol. 45: 21-25 [Full Text]  
• MARY, C., FARAUT, F., DROGOUL, M.-P., XERIDAT, B., SCHLEINITZ, N., CUISENIER, B., DUMON, H. (2006). REFERENCE VALUES FOR LEISHMANIA INFANTUM PARASITEMIA IN DIFFERENT CLINICAL PRESENTATIONS: QUANTITATIVE POLYMERASE CHAIN REACTION FOR THERAPEUTIC MONITORING AND PATIENT FOLLOW-UP. Am J Trop Med Hyg 75: 858-863 [Abstract] [Full Text]  
• Sundar, S., Maurya, R., Singh, R. K., Bharti, K., Chakravarty, J., Parekh, A., Rai, M., Kumar, K., Murray, H. W. (2006). Rapid, Noninvasive Diagnosis of Visceral Leishmaniasis in India: Comparison of Two Immunochromatographic Strip Tests for Detection of Anti-K39 Antibody. J. Clin. Microbiol. 44: 251-253 [Abstract] [Full Text]