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*Leishmaniasis

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Journal of Clinical Microbiology, December 2006, p. 4455-4458, Vol. 44, No. 12
0095-1137/06/$08.00+0     doi:10.1128/JCM.00921-06
Copyright © 2006, American Society for Microbiology. All Rights Reserved.

Use of Noninvasive Markers To Detect Leishmania Infection in Asymptomatic Human Immunodeficiency Virus-Infected Patients{triangledown}

José A. García-García,1 Joaquina Martín-Sánchez,2 Montserrat Gállego,3 Antonio Rivero-Román,4 Angela Camacho,4 Cristina Riera,3 Francisco Morillas-Márquez,2 Salvador Vergara,1 Juan Macías,1 and Juan A. Pineda1*

Unidad Clínica de Enfermedades Infecciosas, Hospital Universitario de Valme, Sevilla,1 Departamento de Parasitología, Facultad de Farmacia, Universidad de Granada, Granada,2 Laboratorio de Parasitología, Facultad de Farmacia, Universidad de Barcelona, Barcelona,3 Unidad de Enfermedades Infecciosas, Servicio de Medicina Interna, Hospital Universitario Reina Sofía, Córdoba, Spain4

Received 2 May 2006/ Returned for modification 27 July 2006/ Accepted 6 October 2006

Visceral leishmaniasis (VL) caused by Leishmania infantum is a common disease in human immunodeficiency virus (HIV)-infected people in the Mediterranean basin. However, most such cases are asymptomatic, and little information about the prevalence of these infections in HIV-infected individuals is available. The aim of this study was to assess the prevalence of subclinical infection and the relationship between several Leishmania infection markers by noninvasive methods in asymptomatic HIV-infected patients from Southern Spain. Ninety-two HIV-infected patients, who were consecutively attended at the participant hospitals in 2004, were invited to participate in this study. These patients were asymptomatic and without any history of cutaneous or visceral leishmaniasis. Leishmania kinetoplast DNA (kDNA) was amplified from peripheral blood samples from 28 (30.4%) of these HIV-infected subjects. Sera from three (3.5%) patients tested positive for Leishmania by an enzyme-linked immunoassay. Two patients (2.4%) showed a specific 16-kDa band by Western blotting. In contrast, none of the patients showed a positive agglutination of urine. The leishmanin skin test was positive for four (4.3%) patients. None of the patients with a PCR-positive result showed a positive reaction by enzyme-linked immunoassay or by specific bands in Western blotting or had a positive leishmanin skin test. In conclusion, L. infantum kDNA was detected in a large proportion of asymptomatic HIV-infected patients, although a demonstrable cellular or humoral immune response to this parasite was not shown. Conversely, Leishmania antigen in urine was not detected in these patients.

* Corresponding author. Mailing address: Unidad Clínica de Enfermedades Infecciosas, Hospital Universitario de Valme, Carretera de Cádiz s/n, 41014 Seville, Spain. Phone: 34-95-5015747. Fax: 34-95-5015747. E-mail: japineda{at}nacom.es.

{triangledown} Published ahead of print on 18 October 2006.

Journal of Clinical Microbiology, December 2006, p. 4455-4458, Vol. 44, No. 12
0095-1137/06/$08.00+0     doi:10.1128/JCM.00921-06
Copyright © 2006, American Society for Microbiology. All Rights Reserved.



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