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de Oliveira Mendes-Aguiar C, do Monte Alves M, de Albuquerque Lopes Machado A, de Góis Monteiro GR, Medeiros IM, Queiroz JW, Lima ID, Pearson RD, Wilson ME, Glesby MJ, do Nascimento ELT, Jerônimo SMB. T-cell activation, senescence, and exhaustion in asymptomatic HIV/Leish mania infantum co-infection. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.03.06.23286828. [PMID: 36945413 PMCID: PMC10029033 DOI: 10.1101/2023.03.06.23286828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
Abstract
Background Leishmania infantum is an opportunistic parasitic infection. An immunocompromised state increases the risk of converting asymptomatic infection to symptomatic visceral leishmaniasis (VL), which has a ~5% fatality rate even with treatment. HIV coinfection increases the risk of death from VL. Methods A cross-sectional study was performed between 2014 and 2016 to determine the prevalence of L. infantum infection in HIV positive subjects residing in the state of Rio Grande do Norte, Brazil (n=1,372) and of these a subgroup of subjects were followed longitudinally. Subsequent incident cases of VL were ascertained from a public health database through 2018. A subgroup (n=69) of the cross-sectional study subjects was chosen to assess immune status (T cell activation, senescence, exhaustion) and outcome. The data were compared between asymptomatic HIV+/L. infantum+ (HIV/Leish), symptomatic visceral leishmaniasis (VL), recovered VL, DTH+ (Delayed-Type Hypersensitivity response - Leishmanin skin test), AIDS/VL, HIV+ only (HIV+), and Non-HIV/Non L. infantum infection (control subjects). Results The cross-sectional study showed 24.2% of HIV+ subjects had positive anti-IgG Leishmania antibodies. After 3 years, 2.4% (8 of 333) of these HIV/Leish coinfected subjects developed AIDS/VL, whereas 1.05% (11 of 1,039) of HIV subjects with negative leishmania serology developed AIDS/VL. Poor adherence to antiretroviral therapy (p=0.0008) or prior opportunistic infections (p=0.0007) was associated with development of AIDS/VL. CD4+ (p=0.29) and CD8+ (p=0.38) T cells counts or viral load (p=0.34) were similar between asymptomatic HIV/Leish and HIV subjects. However, activated CD8+CD38+HLA-DR+ T cells were higher in asymptomatic HIV/Leish than HIV group. Likewise, senescent (CD57+) or exhausted (PD1+) CD8+ T cells were higher in asymptomatic HIV/Leish than in AIDS/VL or HIV groups. Conclusion Although asymptomatic HIV/Leish subjects had normal and similar CD4+ and CD8+ T cells counts, their CD8+T cells had increased activation, senescence, and exhaustion, which could contribute to risk of developing VL.
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Affiliation(s)
| | - Manoella do Monte Alves
- Institute of Tropical Medicine of Rio Grande do Norte, Federal University of Rio Grande do Norte, Natal, RN, Brazil
- Department of Infectious Disease, Health Science Center, Federal University of Rio Grande do Norte, Natal, RN, Brazil
- Health Graduate Program, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | | | | | - Iara Marques Medeiros
- Institute of Tropical Medicine of Rio Grande do Norte, Federal University of Rio Grande do Norte, Natal, RN, Brazil
- Department of Infectious Disease, Health Science Center, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Jose Wilton Queiroz
- Institute of Tropical Medicine of Rio Grande do Norte, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Iraci Duarte Lima
- Institute of Tropical Medicine of Rio Grande do Norte, Federal University of Rio Grande do Norte, Natal, RN, Brazil
- State of Rio Grande do Norte Health Secretariat, Natal, RN, Brazil
| | - Richard D. Pearson
- Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Mary E. Wilson
- Departments of Internal Medicine and Microbiology & Immunology, University of Iowa and the Veterans’ Affairs Medical Center, Iowa City, IA, USA
| | - Marshall J. Glesby
- Division of Infectious Disease, Weill Cornell Medical College, New York, NY, USA
| | - Eliana Lúcia Tomaz do Nascimento
- Institute of Tropical Medicine of Rio Grande do Norte, Federal University of Rio Grande do Norte, Natal, RN, Brazil
- Department of Infectious Disease, Health Science Center, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Selma Maria Bezerra Jerônimo
- Institute of Tropical Medicine of Rio Grande do Norte, Federal University of Rio Grande do Norte, Natal, RN, Brazil
- Institute of Science and Technology of Tropical Diseases, Natal, RN, Brazil
- Department of Biochemistry, Federal University of Rio Grande do Norte, Natal, RN, Brazil
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Asymptomatic Leishmania infection in humans: A systematic review. J Infect Public Health 2023; 16:286-294. [PMID: 36630836 DOI: 10.1016/j.jiph.2022.12.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/09/2022] [Accepted: 12/28/2022] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Leishmaniasis is a highly prevalent neglected tropical disease. It mainly presents as two forms: cutaneous and visceral leishmaniasis, the latter being the most severe form. However, asymptomatic cases of Leishmania infection result in an increase in the underreporting and transmission of the protozoan OBJECTIVES: In this study, articles on the incidence of asymptomatic Leishmania infection were systematically reviewed. METHODS The publications identified in the Medline/PubMed and Science Direct databases included 4568 articles. Inclusion, exclusion, and eligibility criterion analysis resulted in 83 articles being retained. These studies were mostly performed in Brazil (n = 26) and India (n = 15). RESULTS Several detection techniques have been used for diagnosis. Among the species found were L. infantum and L. donovani, which result in visceral leishmaniasis, and L. amazonensis, L. braziliensis, and L. panamensis. The incidence rates varied between the analyzed locations, largely due to sampling and the presence or absence of endemism in the regions. The largest populations analyzed were in two studies performed in India and Nepal. One of these studies evaluated 32,529 people and the incidence rate was 8.3% (n = 2702), while the other study evaluated 21,267 people and the incidence rate was 1.76% (n = 375). Only 14.28% of the studies investigated leishmaniasis in blood donors. Preexisting diseases have also been reported. CONCLUSION The findings of this systematic review present the incidence of cases of asymptomatic Leishmania infection worldwide, in addition to detailing the studies and offering information for researchers and health authorities to seek alternatives to reduce the number of leishmaniasis cases.
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Kantzanou M, Karalexi MA, Theodoridou K, Kostares E, Kostare G, Loka T, Vrioni G, Tsakris A. Prevalence of visceral leishmaniasis among people with HIV: a systematic review and meta-analysis. Eur J Clin Microbiol Infect Dis 2023; 42:1-12. [PMID: 36427170 PMCID: PMC9816214 DOI: 10.1007/s10096-022-04530-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 11/16/2022] [Indexed: 11/27/2022]
Abstract
Leishmaniasis is a parasitic infection expressing different clinical phenotypes. Visceral leishmaniasis (VL) is considered an opportunistic infection among people with human immunodeficiency virus (HIV). The objective of this review was to identify published data on the prevalence of Leishmania spp. infection among PWH and to define particular determinants that affect critically the epidemiological characteristics of VL-HIV coinfection and, potentially, its burden on public health. Two independent reviewers conducted a systematic literature search until June 30, 2022. Meta-analyses were conducted using random-effects models to calculate the summary prevalence and respective 95% confidence intervals (CI) of leishmaniasis among PWH. Meta-regression analysis was performed to investigate the impact of putative effect modifiers, such as the mean CD4 cell count, on the major findings. Thirty-four studies were eligible, yielding a summary prevalence of 6% (95%CI, 4-11%) for leishmaniasis (n = 1583) among PWH (n = 85,076). Higher prevalence rates were noted in Asia (17%, 95%CI, 9-30%) and America (9%, 95%CI, 5-17%) than in Europe (4%, 95%CI, 2-8%). Prevalence rates were significantly mediated by the age, sex, and CD4 cell count of participants. Heterogeneity remained significant in all meta-analyses (p < 0.0001). In the majority of included studies, people were coinfected with HIV and Leishmania species associated with VL, as opposed to those associated with cutaneous leishmaniasis. No sign of publication bias was shown (p = 0.06). Our summary of published studies on leishmaniasis among PWH is important to provide prevalence estimates and define potential underlying factors that could guide researchers to generate and further explore specific etiologic hypotheses.
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Affiliation(s)
- Maria Kantzanou
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 115 27, Athens, Greece
| | - Maria A Karalexi
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 115 27, Athens, Greece
| | - Kalliopi Theodoridou
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 115 27, Athens, Greece
- Department of Microbiology, Andreas Syggros Hospital for Skin and Venereal Diseases, National and Kapodistrian University of Athens, 161 21, Athens, Greece
| | - Evangelos Kostares
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 115 27, Athens, Greece
| | - Georgia Kostare
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 115 27, Athens, Greece
| | - Thalia Loka
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 115 27, Athens, Greece
| | - Georgia Vrioni
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 115 27, Athens, Greece
| | - Athanassios Tsakris
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 115 27, Athens, Greece.
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Mounia A, Mohamed E, Mohamed H, Samia B. A Community Based Survey of Knowledge, Attitudes, and Practices Concerning Leishmaniasis in Central Morocco. J Community Health 2022; 47:932-942. [PMID: 35921052 DOI: 10.1007/s10900-022-01126-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2022] [Indexed: 12/26/2022]
Abstract
Leishmaniasis is a major health problem caused by a protozoan of the genus Leishmania, most commonly transmitted by infected female sand flies. Intersectoral collaboration is essential for the implementation of integrated vector management control with community participation. The present study aims to evaluate the knowledge, attitude and practices of the population toward leishmaniasis in central Morocco. A quantitative cross-sectional study was conducted using an administered questionnaire assisted by health professionals, on 750 people in the Marrakech Safi, endemic region of cutaneous leishmaniasis (CL). Of those, 702 agreed to be recruited for our study, of which 63,5% were women, 48,1% were aged between 18 and 40 years, and more than half of the participants (60%) were from rural areas. Overall, the knowledge, attitude and practices (KAPs) for leishmaniasis are too poor for more than 85% of the population in the study area. Basic knowledge and perceptions of leishmaniasis were good for 14,6% of respondents. While, 4,5% of the members had good knowledge of CL, only 0,7% had good level of knowledge about vesciral leishmaniasis (VL). Furthermore 3,7% of those polled have favorable attitudes and preventive practices. No association was found between knowledge and age, province or occupation. However, rural residents were four times more likely than urbain residents to have good basic knowledge (ORA = 4,74; CI95%: 1,04 -22,05). In addition, the female gender also has the chance to possess good basic knowledge and perceptions 3 times more than the men (ORA = 3,18; CI95%: 1,16 -8,69). The low level of KAPs regarding leishmaniasis proves the lack of community participation in the fight against leishmaniasis in central Morocco.
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Affiliation(s)
- Amane Mounia
- Microbial Biotechnologies, Agrosciences and Environment Laboratory (BioMAgE), Research Unit Labelled CNRST N°4, Faculty of Sciences Semlalia, Cadi Ayyad University, Marrakech, Morocco.
| | - Echchakery Mohamed
- Microbial Biotechnologies, Agrosciences and Environment Laboratory (BioMAgE), Research Unit Labelled CNRST N°4, Faculty of Sciences Semlalia, Cadi Ayyad University, Marrakech, Morocco.,Epidemiology and Biomedical Unit, Laboratory of Sciences and Health Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat, Morocco
| | - Hafidi Mohamed
- Microbial Biotechnologies, Agrosciences and Environment Laboratory (BioMAgE), Research Unit Labelled CNRST N°4, Faculty of Sciences Semlalia, Cadi Ayyad University, Marrakech, Morocco
| | - Boussaa Samia
- Microbial Biotechnologies, Agrosciences and Environment Laboratory (BioMAgE), Research Unit Labelled CNRST N°4, Faculty of Sciences Semlalia, Cadi Ayyad University, Marrakech, Morocco.,Ministry of Health and Social Protection, ISPITS-Higher Institute of Nursing and Technical Health Occupations, Rabat, Morocco
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Saini I, Joshi J, Kaur S. Unwelcome prevalence of leishmaniasis with several other infectious diseases. Int Immunopharmacol 2022; 110:109059. [DOI: 10.1016/j.intimp.2022.109059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 07/12/2022] [Accepted: 07/12/2022] [Indexed: 11/17/2022]
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Ibarra-Meneses AV, Corbeil A, Wagner V, Onwuchekwa C, Fernandez-Prada C. Identification of asymptomatic Leishmania infections: a scoping review. Parasit Vectors 2022; 15:5. [PMID: 34983616 PMCID: PMC8727076 DOI: 10.1186/s13071-021-05129-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 12/11/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Asymptomatic Leishmania infection may play an important role in the transmission of the parasite in endemic areas. At present there is no consensus on the definition of asymptomatic Leishmania infection, nor is there a safe and accessible gold standard test for its identification. METHODS This paper presents a scoping review to summarize definitions of asymptomatic Leishmania infection found in the literature, as well as to detail the approach (molecular, serological, cellular, and/or parasitological tests) used by researchers to identify this asymptomatic population. A scoping review of published and gray literature related to asymptomatic Leishmania infection was conducted; retrieved citations were screened based on predefined eligibility criteria, and relevant data items were extracted from eligible articles. The analysis is descriptive and is presented using tables, figures, and thematic narrative synthesis. RESULTS We conducted a screening of 3008 articles, of which 175 were selected for the full review. Of these articles, we selected 106 that met the inclusion criteria. These articles were published between 1991 and 2021, and in the last 5 years, up to 38 articles were reported. Most of the studies were conducted in Brazil (26%), Spain (14%), India (12%), Bangladesh (10%), and Ethiopia (7%). Of the studies, 84.9% were conducted in the immunocompetent population, while 15.1% were conducted in the immunosuppressed population (HIV, immunosuppressive drugs, and organ transplantation population). We report 14 different techniques and 10 strategies employed by researchers to define asymptomatic Leishmania infection in an endemic area. CONCLUSIONS The definition of asymptomatic Leishmania infection is not unified across the literature, but often includes the following criteria: residence (or extended stay) in a Leishmania-endemic area, no reported signs/symptoms compatible with leishmaniasis, and positive on a combination of serological, molecular, cellular, and/or parasitological tests. Caution is recommended when comparing results of different studies on the subject of asymptomatic infections, as the reported prevalence cannot be confidently compared between areas due to the wide variety of tests employed by research groups. More research on the importance of asymptomatic immunosuppressed and immunocompetent Leishmania-positive populations in leishmaniasis epidemiology is required.
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Affiliation(s)
- Ana Victoria Ibarra-Meneses
- Département de Pathologie et Microbiologie, Faculté de Médecine Vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada.,The Research Group on Infectious Diseases in Production Animals (GREMIP), Faculty of Veterinary Medicine, Université de Montréal, Saint Hyacinthe, Canada
| | - Audrey Corbeil
- Département de Pathologie et Microbiologie, Faculté de Médecine Vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada.,The Research Group on Infectious Diseases in Production Animals (GREMIP), Faculty of Veterinary Medicine, Université de Montréal, Saint Hyacinthe, Canada
| | - Victoria Wagner
- Département de Pathologie et Microbiologie, Faculté de Médecine Vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada.,The Research Group on Infectious Diseases in Production Animals (GREMIP), Faculty of Veterinary Medicine, Université de Montréal, Saint Hyacinthe, Canada
| | - Chukwuemeka Onwuchekwa
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Christopher Fernandez-Prada
- Département de Pathologie et Microbiologie, Faculté de Médecine Vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada. .,The Research Group on Infectious Diseases in Production Animals (GREMIP), Faculty of Veterinary Medicine, Université de Montréal, Saint Hyacinthe, Canada.
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7
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Kassardjian AA, Yim KM, Rabi S, Liang TZ, Kim GH, Ochoa MT, Sattah MV, Ahronowitz IZ. Diffuse cutaneous leishmaniasis and HIV co-infection: A case report and review of the literature. J Cutan Pathol 2021; 48:802-806. [PMID: 33611800 DOI: 10.1111/cup.13993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 02/16/2021] [Accepted: 02/17/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Ari A Kassardjian
- Keck School of Medicine of USC, University of Southern California, Los Angeles, California, USA
| | - Kaitlyn M Yim
- Keck School of Medicine of USC, University of Southern California, Los Angeles, California, USA
| | - Sina Rabi
- Keck School of Medicine of USC, University of Southern California, Los Angeles, California, USA
| | - Tom Z Liang
- Keck School of Medicine of USC, University of Southern California, Los Angeles, California, USA
| | - Gene H Kim
- Keck School of Medicine of USC, University of Southern California, Los Angeles, California, USA
| | - Maria T Ochoa
- Keck School of Medicine of USC, University of Southern California, Los Angeles, California, USA
| | - Martin V Sattah
- Keck School of Medicine of USC, University of Southern California, Los Angeles, California, USA
| | - Iris Z Ahronowitz
- Keck School of Medicine of USC, University of Southern California, Los Angeles, California, USA
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Guedes DL, Justo AM, Barbosa Júnior WL, Silva EDD, Aquino SRD, Lima Junior MSDC, Montarroyos U, Bezerra GSN, Vieira AVB, Pereira VRA, Medeiros ZMD. Asymptomatic Leishmania infection in HIV-positive outpatients on antiretroviral therapy in Pernambuco, Brazil. PLoS Negl Trop Dis 2021; 15:e0009067. [PMID: 33476331 PMCID: PMC7853496 DOI: 10.1371/journal.pntd.0009067] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 02/02/2021] [Accepted: 12/11/2020] [Indexed: 11/23/2022] Open
Abstract
Background Visceral leishmaniasis (VL) in HIV-positive individuals is a global health problem. HIV-Leishmania coinfection worsens prognosis and mortality risk, and HIV-Leishmania coinfected individuals are more susceptible to VL relapses. Early initiation of antiretroviral therapy can protect against Leishmania infection in individuals living in VL-endemic areas, and regular use of antiretrovirals might prevent VL relapses in these individuals. We conducted a cross-sectional study in Petrolina, Brazil, an VL-endemic area, to estimate the prevalence of asymptomatic Leishmania cases among HIV-positive outpatients. Methods We invited any HIV-positive patients, aged ≥ 18-years-old, under antiretroviral therapy, and who were asymptomatic for VL. Patients were tested for Leishmania with enzyme-linked immunosorbent assays (ELISA)-rK39, immunochromatographic test (ICT)-rK39, direct agglutination test (DAT), latex agglutination test (KAtex), and conventional polymerase chain reaction (PCR). HIV-Leishmania coinfection was diagnosed when at least one VL test was positive. Results A total of 483 patients were included. The sample was predominantly composed of single, < 48-years-old, black/pardo, heterosexual males, with fewer than 8 years of schooling. The prevalence of asymptomatic HIV-Leishmania coinfection was 9.11% (44/483). HIV mono-infected and HIV-Leishmania coinfected groups differed statistically significantly in terms of race (p = 0.045), marital status (p = 0.030), and HIV viral load (p = 0.046). Black/pardo patients, married patients, and those with an HIV viral load up to 100,000 copies/ml presented higher odds for HIV-Leishmania coinfection. Conclusions A considerable number of asymptomatic Leishmania cases were observed among HIV-positive individuals in a VL-endemic area. Given the potential impact on transmission and health costs, as well as the impact on these coinfected individuals, studies of asymptomatic Leishmania carriers can be useful for guiding public health policies in VL-endemic areas aiming to control and eliminate the disease. Every year up to 90,000 new cases of visceral leishmaniasis (VL) occurs globally. One of the most neglected diseases, VL is endemic in 60 countries in four continents. Brazil is one of seven countries in which 90% of all cases in the world occur. When co-occurring with HIV, VL tends to be more severe than in HIV-negative persons, leading to worse prognosis and frequent relapses. In this study HIV-positive outpatients, aged 18 years or older, under antiretroviral therapy, who were asymptomatic for VL, were tested for Leishmania. We observed a prevalence of 9.11% (44/483) of HIV-Leishmania coinfection. For those HIV-positive/Leishmania-negative individuals who live in VL-endemic areas, early initiation of antiretroviral therapy can be a protective factor against Leishmania infection. On the other hand, for HIV-Leishmania coinfected individuals who regularly use antiretrovirals might prevent VL relapses. Studies centering on asymptomatic Leishmania carriers can be useful for guiding public health measures in VL-endemic areas seeking to control and eliminate the disease.
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Affiliation(s)
- Diego Lins Guedes
- Curso de Medicina, Núcleo de Ciências da Vida, Centro Acadêmico do Agreste, Universidade Federal de Pernambuco, Caruaru, Brasil.,Departamento de Parasitologia, Instituto Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, Brasil
| | - Alda Maria Justo
- Núcleo de Pós-Graduação, Faculdade de Ciências Médicas, Universidade de Pernambuco, Recife, Brasil
| | | | - Elis Dionísio da Silva
- Departamento de Imunologia, Instituto Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, Brasil
| | | | | | - Ulisses Montarroyos
- Núcleo de Pós-Graduação, Faculdade de Ciências Médicas, Universidade de Pernambuco, Recife, Brasil
| | | | | | | | - Zulma Maria de Medeiros
- Departamento de Parasitologia, Instituto Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, Brasil.,Núcleo de Pós-Graduação, Faculdade de Ciências Médicas, Universidade de Pernambuco, Recife, Brasil
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9
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Daoudi M, Boussaa S, Hafidi M, Boumezzough A. Potential distributions of phlebotomine sandfly vectors of human visceral leishmaniasis caused by Leishmania infantum in Morocco. MEDICAL AND VETERINARY ENTOMOLOGY 2020; 34:385-393. [PMID: 32103524 DOI: 10.1111/mve.12434] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 01/31/2020] [Accepted: 02/03/2020] [Indexed: 06/10/2023]
Abstract
Zoonotic visceral leishmaniasis is a common vector-borne systemic disease caused by Leishmania infantum (Kinetoplastida: Trypanosomatidae). In Morocco the situation is complex: many sandfly species have been collected in areas in which the disease is endemic, but only Phlebotomus ariasi, Phlebotomus perniciosus and Phlebotomus longicuspis (Diptera: Psychodidae) have been confirmed to have vectorial roles. The objective of the present study was to ascertain the potential distribution of L. infantum and its vectors in Morocco, using ecological niche modelling. Vector records were obtained from field collections of the Laboratory team and from previously published entomological observations. Epidemiological data for L. infantum modelling were obtained from Moroccan Ministry of Health reports. The jackknife test indicated that the bioclimatic variables with the greatest influence on model development for all species were annual precipitation and precipitation in the driest quarter of the year. MaxEnt model representations for sandfly species that act as vectors of L. infantum showed the widespread geographic distribution of these species in Morocco, specifically in northern and central Morocco, where foci of visceral leishmaniasis are found. The ecological niche modelling points out areas in which the probability of occurrence of these species is higher. This information should be considered as a starting point for further research to fully elucidate the ecology and epidemiology of these species, as well as of the pathogens they transmit.
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Affiliation(s)
- M Daoudi
- Microbial Biotechnologies, Agrosciences and Environment Laboratory (BioMAgE), Faculty of Sciences Semlalia, Cadi Ayyad University, Marrakesh, Morocco
| | - S Boussaa
- Microbial Biotechnologies, Agrosciences and Environment Laboratory (BioMAgE), Faculty of Sciences Semlalia, Cadi Ayyad University, Marrakesh, Morocco
- ISPITS-Higher Institute of Nursing and Health Techniques, Ministry of Health, Marrakesh, Morocco
| | - M Hafidi
- Microbial Biotechnologies, Agrosciences and Environment Laboratory (BioMAgE), Faculty of Sciences Semlalia, Cadi Ayyad University, Marrakesh, Morocco
| | - A Boumezzough
- Microbial Biotechnologies, Agrosciences and Environment Laboratory (BioMAgE), Faculty of Sciences Semlalia, Cadi Ayyad University, Marrakesh, Morocco
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10
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Cunha MA, Celeste BJ, Kesper N, Fugimori M, Lago MM, Ibanes AS, Ouki LM, Neto EAS, Fonseca FF, Silva MAL, Júnior WLB, Lindoso JAL. Frequency of Leishmania spp. infection among HIV-infected patients living in an urban area in Brazil: a cross-sectional study. BMC Infect Dis 2020; 20:885. [PMID: 33238943 PMCID: PMC7686951 DOI: 10.1186/s12879-020-05622-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Accepted: 11/17/2020] [Indexed: 11/13/2022] Open
Abstract
Background There is little information about the frequency of Leishmania infection in asymptomatic people living with HIV (PLWH) and about the performance of laboratory diagnostic methods in coinfected patients in Latin America. The main objective of this study is to evaluate the frequency of Leishmania spp. infection in HIV-infected patients living in an urban area in Brazil. Methods To detect Leishmania infection, diagnostic tests were performed to detect anti-Leishmania antibodies (ELISA using Leptomonas seymouri antigens; ELISA using rK39 antigens; ELISA using rK28 antigens; indirect fluorescent-antibody test (IFAT); direct agglutination test (DAT)) and Leishmania DNA (polymerase chain reaction (PCR) with the target genes kDNA and ITS-1). Results The frequency of at least one positive test was 15%. For ELISA using Leptomonas antigens and IFAT, there was an association between CD4+ T lymphocyte counts and test positivity, with a higher positivity of these tests in more immunosuppressed patients (CD4+ T cell count < 200/mm3). Conclusions According to our data, there was a high prevalence of Leishmania spp. infections in this population living with HIV. Although there is the possibility of cross-reaction, some tests that are considered highly specific for the diagnosis of Leishmania infection were positive. There was also an association between the positivity of some tests studied and lower values of CD4+ T lymphocytes.
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Affiliation(s)
- M A Cunha
- Department of Infectious Diseases, Federal University of Rio Grande do Norte, Rua Cônego Monte, 110, Quintas, Natal/RN, Rio Grande do Norte, 59037-170, Brazil. .,Department of Infectious and Parasitic Diseases, University of São Paulo Medical School, Sao Paulo, Sao Paulo, Brazil.
| | - B J Celeste
- Laboratory of Seroepidemiology and Immunobiology, Institute of Tropical Medicine of São Paulo, Sao Paulo, Sao Paulo, Brazil
| | - N Kesper
- Laboratory of Protozoology, Institute of Tropical Medicine of São Paulo, Sao Paulo, Sao Paulo, Brazil
| | - M Fugimori
- Laboratory of Seroepidemiology and Immunobiology, Institute of Tropical Medicine of São Paulo, Sao Paulo, Sao Paulo, Brazil
| | - M M Lago
- Outpatient sector, Emilio Ribas Institute for Infectious Diseases, Sao Paulo, Sao Paulo, Brazil
| | - A S Ibanes
- Outpatient sector, Emilio Ribas Institute for Infectious Diseases, Sao Paulo, Sao Paulo, Brazil
| | - L M Ouki
- Outpatient sector, Emilio Ribas Institute for Infectious Diseases, Sao Paulo, Sao Paulo, Brazil
| | - E A Simões Neto
- Department of Medicine Course, Federal University of Maranhão, Pinheiro, Maranhão, Brazil
| | - F F Fonseca
- Department of Diseases of Chronic Conditions and Sexually Transmitted Infections, Ministry of Health of Brazil, Brasília, Federal District, Brazil
| | - M A L Silva
- Parasitology, Aggeu Magalhães Research Center, Recife, Pernambuco, Brazil
| | - W L Barbosa Júnior
- Parasitology, Aggeu Magalhães Research Center, Recife, Pernambuco, Brazil
| | - J A L Lindoso
- Department of Infectious and Parasitic Diseases, University of São Paulo Medical School, Sao Paulo, Sao Paulo, Brazil.,Laboratory of Protozoology, Institute of Tropical Medicine of São Paulo, Sao Paulo, Sao Paulo, Brazil.,Outpatient sector, Emilio Ribas Institute for Infectious Diseases, Sao Paulo, Sao Paulo, Brazil
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11
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Machado AS, Ramos FF, Santos TTO, Costa LE, Ludolf F, Lage DP, Bandeira RS, Tavares GSV, Oliveira-da-Silva JA, Steiner BT, Chaves AT, Oliveira JS, Chávez-Fumagalli MA, de Magalhães-Soares DF, Silveira JAG, Duarte MC, Machado-de-Ávila RA, Lyon S, Gonçalves DU, Caligiorne RB, Coelho EAF. A new Leishmania hypothetical protein can be used for accurate serodiagnosis of canine and human visceral leishmaniasis and as a potential prognostic marker for human disease. Exp Parasitol 2020; 216:107941. [PMID: 32622940 DOI: 10.1016/j.exppara.2020.107941] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 06/10/2020] [Accepted: 06/14/2020] [Indexed: 11/26/2022]
Abstract
Distinct antigens have been evaluated with diagnostic purpose for canine and human visceral leishmaniasis (VL), and variable sensitivity and specificity values have been obtained in the assays. In the present study, a Leishmania infantum hypothetical protein called LiHyG, which was identified in an immunoproteomics study in Leishmania infantum amastigote extracts by antibodies in VL dogs sera; was cloned, expressed, purified and evaluated as a recombinant protein (rLiHyG) for the diagnosis of canine and human disease. The recombinant amastigote-specific A2 protein (rA2) and a soluble L. infantum protein extract (SLA) were used as controls. For canine VL, the sensitivity values were of 100%, 57.29% and 48.57%, when rLiHyG, rA2 and SLA were used, respectively, while the specificity values were of 100%, 81.43% and 88.57%, respectively. In addition, AUC values were of 1.00, 0.72 and 0.65, when rLiHyG, rA2 and SLA were used, respectively, while accuracy was of 100%, 72.38% and 75.24%, respectively. For human VL, the sensitivity values were of 100%, 84.00% and 88.00%, when rLiHyG, rA2 and SLA were used, respectively, while the specificity values were of 100%, 58.75% and 73.75%, respectively. In addition, AUC values were of 1.00, 0.76 and 0.83, when rLiHyG, rA2 and SLA were used, respectively, while accuracy was of 100%, 64.8% and 66.6%, respectively. The prognostic role of rLiHyG in the human VL was also evaluated, by means of post-therapeutic serological follow-up with sera samples collected before and six months after treatment. Results showed that treated patients presented significant reductions in the anti-rLiHyG IgG, IgG1, and IgG2 antibody levels, with results being similar to those found in healthy subjects. Testing the rA2 protein and SLA as antigens, lower IgG, IgG1, and IgG2 levels were also found, although they were higher after treatment than those obtained for rLiHyG. In conclusion, results suggested that rLiHyG could be considered for future studies as a diagnostic and/or prognostic marker for canine and human VL.
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Affiliation(s)
- Amanda S Machado
- Instituto de Ensino e Pesquisa, Santa Casa de Belo Horizonte, Rua Domingos Vieira, 590, Santa Efigênia, 30150-240, Belo Horizonte, Minas Gerais, Brazil; Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, 30130-100, Minas Gerais, Brazil
| | - Fernanda F Ramos
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, 30130-100, Minas Gerais, Brazil
| | - Thaís T O Santos
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, 30130-100, Minas Gerais, Brazil
| | - Lourena E Costa
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, 30130-100, Minas Gerais, Brazil
| | - Fernanda Ludolf
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, 30130-100, Minas Gerais, Brazil
| | - Daniela P Lage
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, 30130-100, Minas Gerais, Brazil
| | - Raquel S Bandeira
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, 30130-100, Minas Gerais, Brazil
| | - Grasiele S V Tavares
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, 30130-100, Minas Gerais, Brazil
| | - João A Oliveira-da-Silva
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, 30130-100, Minas Gerais, Brazil
| | - Bethina T Steiner
- Programa de Pós-Graduação em Ciências da Saúde, Universidade do Extremo Sul Catarinense, Criciúma, 88806-000, Santa Catarina, Brazil
| | - Ana T Chaves
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, 30130-100, Minas Gerais, Brazil
| | - Jamil S Oliveira
- Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, 31270-901, Minas Gerais, Brazil
| | - Miguel A Chávez-Fumagalli
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, 30130-100, Minas Gerais, Brazil
| | - Danielle F de Magalhães-Soares
- Departamento de Medicina Veterinária Preventiva, Escola de Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, 31270-901, Minas Gerais, Brazil
| | - Julia A G Silveira
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, 31270-901, Minas Gerais, Brazil
| | - Mariana C Duarte
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, 30130-100, Minas Gerais, Brazil
| | - Ricardo A Machado-de-Ávila
- Programa de Pós-Graduação em Ciências da Saúde, Universidade do Extremo Sul Catarinense, Criciúma, 88806-000, Santa Catarina, Brazil
| | - Sandra Lyon
- Fundação Hospitalar do Estado de Minas Gerais, Hospital Eduardo de Menezes, Belo Horizonte, 30622-020, Minas Gerais, Brazil
| | - Denise U Gonçalves
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, 30130-100, Minas Gerais, Brazil
| | - Rachel B Caligiorne
- Instituto de Ensino e Pesquisa, Santa Casa de Belo Horizonte, Rua Domingos Vieira, 590, Santa Efigênia, 30150-240, Belo Horizonte, Minas Gerais, Brazil
| | - Eduardo A F Coelho
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, 30130-100, Minas Gerais, Brazil.
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12
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Molina R, Jiménez M, García-Martínez J, San Martín JV, Carrillo E, Sánchez C, Moreno J, Alves F, Alvar J. Role of asymptomatic and symptomatic humans as reservoirs of visceral leishmaniasis in a Mediterranean context. PLoS Negl Trop Dis 2020; 14:e0008253. [PMID: 32324738 PMCID: PMC7200008 DOI: 10.1371/journal.pntd.0008253] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 05/05/2020] [Accepted: 03/26/2020] [Indexed: 12/20/2022] Open
Abstract
Background In the Mediterranean basin, Leishmania infantum is the causative agent of visceral leishmaniasis (VL), a zoonosis in which the dog is the primary domestic reservoir, although wildlife may have a leading role in the sylvatic cycle of the disease in some areas. Infections without disease are very frequent. There is limited information regarding the role that VL patients and asymptomatic infected individuals could be playing in the transmission of L. infantum. Xenodiagnosis of leishmaniasis has been used in this descriptive study to explore the role of symptomatic and asymptomatic infected individuals as reservoirs in a recent focus of leishmaniasis in southwestern Madrid, Spain. Methodology and main findings Asymptomatic blood donors (n = 24), immunocompetent patients who were untreated (n = 12) or treated (n = 11) for visceral leishmaniasis (VL), and immunocompromised patients with VL (n = 3) were enrolled in the study. Their infectivity to Phlebotomus perniciosus was studied by indirect xenodiagnosis on peripheral blood samples. Quantitative polymerase chain reaction of blood samples from immunocompetent patients untreated for VL and immunocompromised untreated, treated and under secondary prophylaxis for VL was performed. Antibodies against Leishmania were studied by indirect fluorescent antibody and rK39-immunochromatographic tests. A lymphoproliferative assay with a soluble Leishmania antigen was used to screen for leishmaniasis infection in the healthy population. Sixty-two xenodiagnostic tests were carried out and 5,080 sand flies were dissected. Positive xenodiagnosis was recorded in four patients, with different sand fly infection rates: 1 immunosuppressed HIV / L. infantum coinfected asymptomatic patient, 1 immunosuppressed patient with multiple myeloma and symptomatic active VL, and 2 immunocompetent patients with untreated active VL. All blood donors were negative for both xenodiagnosis and conventional PCR. Conclusions / Significance There is no consensus amongst authors on the definition of an ‘asymptomatic case’ nor on the tools for screening; we, therefore, have adopted one for the sake of clarity. Immunocompetent subjects, both infected asymptomatics and those treated for VL, are limited in number and appear to have no epidemiological relevance. The impact is limited for immunocompetent patients with untreated active VL, whilst immunosuppressed individuals undergoing immunosuppressive therapy and immunosuppressed individuals HIV / L. infantum coinfected were the most infectious towards sand flies. It is noteworthy that the HIV / L. infantum coinfected patient with asymptomatic leishmaniasis was easily infectious to sand flies for a long time, despite being under continuous prophylaxis for leishmaniasis. Accordingly, screening for latent Leishmania infection in HIV-infected patients is recommended in scenarios where transmission occurs. In addition, screening for VL in HIV-infected patients who have spent time in VL-endemic areas should also be implemented in non-endemic areas. More research is needed to better understand if some asymptomatic coinfected individuals contribute to transmission as ‘super-spreaders’. Leishmaniasis is a set of diseases caused by Leishmania parasites and transmitted through the bites of infected phlebotomine sand fly females during blood ingestion. Visceral leishmaniasis (VL) is caused by Leishmania infantum in the Mediterranean region and dog is the primary domestic reservoir, although we can not ignore the role that wild reservoirs can have under certain conditions. As for the role of the human host in the transmission of the disease is not fully understood. The present work explores this important epidemiological aspect to try to clarify it. The study concludes that asymptomatic infected individuals and the immunocompetent patients treated for VL have no epidemiological impact in the transmission of L. infantum. As for the immunocompetent patients with untreated active VL its impact is limited, whilst immunosupressed patients are the most infectious towards sand flies. Thus, the screening for latent Leishmania infection in HIV-infected patients is recommended in scenarios where transmission occurs.
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Affiliation(s)
- Ricardo Molina
- Laboratory of Medical Entomology, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
- WHO Collaborating Centre for Leishmaniasis, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
- * E-mail: (RM); (MJ); (JA)
| | - Maribel Jiménez
- Laboratory of Medical Entomology, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
- WHO Collaborating Centre for Leishmaniasis, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
- * E-mail: (RM); (MJ); (JA)
| | - Jesús García-Martínez
- Clinical Laboratory Service, Blood Bank, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, Spain
| | - Juan Víctor San Martín
- Internal Medicine Service, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, Spain
| | - Eugenia Carrillo
- WHO Collaborating Centre for Leishmaniasis, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Carmen Sánchez
- WHO Collaborating Centre for Leishmaniasis, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Javier Moreno
- WHO Collaborating Centre for Leishmaniasis, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Fabiana Alves
- Drugs for Neglected Diseases Initiative, Geneva, Switzerland
| | - Jorge Alvar
- Drugs for Neglected Diseases Initiative, Geneva, Switzerland
- * E-mail: (RM); (MJ); (JA)
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13
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Oliveira-da-Silva JA, Machado AS, Ramos FF, Tavares GSV, Lage DP, Ludolf F, Steiner BT, Reis TAR, Santos TTO, Costa LE, Martins VT, Galvani NC, Chaves AT, Oliveira JS, Chávez-Fumagalli MA, de Magalhães-Soares DF, Duarte MC, Menezes-Souza D, Silveira JAG, Moreira RLF, Machado-de-Ávila RA, Tupinambás U, Gonçalves DU, Coelho EAF. Evaluation of Leishmania infantum pyridoxal kinase protein for the diagnosis of human and canine visceral leishmaniasis. Immunol Lett 2020; 220:11-20. [PMID: 31981576 DOI: 10.1016/j.imlet.2020.01.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 01/06/2020] [Accepted: 01/21/2020] [Indexed: 12/27/2022]
Abstract
Visceral leishmaniasis (VL) is a highly neglected disease that is present in several countries worldwide. Present-day treatments against this disease are unsuitable, mainly due to the toxicity and/or high cost of drugs. In addition, the development of vaccines is still insufficient. In this scenario, a prompt VL diagnosis was deemed necessary, although sensitivity and/or specificity values of the tests have been. In this context, new antigenic candidates should be identified to be employed in a more precise diagnosis of canine and human VL. In this light, the present study evaluated the diagnostic efficacy of the Leishmania infantum pyridoxal kinase (PK) protein, applied in its recombinant version (rPK). In addition, one specific B-cell epitope derived of the PK sequence was predicted, synthetized, and evaluated as diagnostic marker. Results in ELISA tests showed that the antigens were highly sensitive to VL identification in dogs and human sera, presenting a low reactivity with VL-related disease samples. The recombinant A2 (rA2) protein and L. infantum antigenic preparation (SLA), used as controls, also proved to be highly sensitive in detecting symptomatic cases, although a low sensitivity was found when asymptomatic sera were analyzed. High cross-reactivity was also found when these antigens were evaluated against VL-related disease samples. The post-therapeutic serological follow-up showed that anti-rPK and anti-peptide IgG antibody levels decreased in significant levels after treatment. By contrast, the presence of high levels of the anti-rA2 and anti-SLA antibodies was still detected after therapy. In conclusion, rPK and its specific B-cell epitope should be considered for future studies as a diagnostic marker for canine and human VL.
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Affiliation(s)
- João A Oliveira-da-Silva
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, 30130-100, Minas Gerais, Brazil
| | - Amanda S Machado
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, 30130-100, Minas Gerais, Brazil; Instituto de Ensino e Pesquisa, Santa Casa de Belo Horizonte. Rua Domingos Vieira, 590, Santa Efigênia, 30150-240, Belo Horizonte, Minas Gerais, Brazil
| | - Fernanda F Ramos
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, 30130-100, Minas Gerais, Brazil
| | - Grasiele S V Tavares
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, 30130-100, Minas Gerais, Brazil
| | - Daniela P Lage
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, 30130-100, Minas Gerais, Brazil
| | - Fernanda Ludolf
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, 30130-100, Minas Gerais, Brazil
| | - Bethina T Steiner
- Programa de Pós-Graduação em Ciências da Saúde, Universidade do Extremo Sul Catarinense, Criciúma, 88806-000, Santa Catarina, Brazil
| | - Thiago A R Reis
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, 30130-100, Minas Gerais, Brazil
| | - Thaís T O Santos
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, 30130-100, Minas Gerais, Brazil
| | - Lourena E Costa
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, 30130-100, Minas Gerais, Brazil
| | - Vívian T Martins
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, 30130-100, Minas Gerais, Brazil
| | - Nathália C Galvani
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, 30130-100, Minas Gerais, Brazil
| | - Ana T Chaves
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, 30130-100, Minas Gerais, Brazil
| | - Jamil S Oliveira
- Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, 31270-901, Minas Gerais, Brazil
| | | | - Danielle F de Magalhães-Soares
- Departamento de Medicina Veterinária Preventiva, Escola de Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, 31270-901, Minas Gerais, Brazil
| | - Mariana C Duarte
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, 30130-100, Minas Gerais, Brazil
| | - Daniel Menezes-Souza
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, 30130-100, Minas Gerais, Brazil
| | - Julia A G Silveira
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, 31270-901, Minas Gerais, Brazil
| | - Ricardo L F Moreira
- Fundação Hospitalar do Estado de Minas Gerais, Hospital Eduardo de Menezes, Belo Horizonte, 30622-020, Minas Gerais, Brazil
| | - Ricardo A Machado-de-Ávila
- Programa de Pós-Graduação em Ciências da Saúde, Universidade do Extremo Sul Catarinense, Criciúma, 88806-000, Santa Catarina, Brazil
| | - Unaí Tupinambás
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, 30130-100, Minas Gerais, Brazil
| | - Denise U Gonçalves
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, 30130-100, Minas Gerais, Brazil
| | - Eduardo A F Coelho
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, 30130-100, Minas Gerais, Brazil.
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14
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Daoudi M, Boussaa S, Echchakery M, Boumezzough A. Risk mapping of human HIV-Leishmaniasis co-infection in Morocco. Heliyon 2019; 5:e02419. [PMID: 31535046 PMCID: PMC6744606 DOI: 10.1016/j.heliyon.2019.e02419] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 08/05/2019] [Accepted: 09/02/2019] [Indexed: 12/17/2022] Open
Abstract
Background HIV/AIDS is frequently associated with opportunistic diseases such as leishmaniasis. Hence, the co-infection HIV-Leishmania spp. is the result of the geographical overlap between leishmaniasis and HIV/AIDS cases. To the best of our knowledge, this is the first report describing the spatial distribution of HIV-Leishmaniasis co-infection in Morocco where both infections are endemic. Methods In the current study, we discuss the HIV-Leishmania spp. co-infection vulnerability in Morocco by using the cartography tools. Thus, epidemiological data of both infections (Leishmaniasis and HIV/AIDS) in different administrative regions of Morocco were collected and co-registered for Digital maps making. Results & conclusion The results showed a high risk of HIV-Leishmania infantum co-infection in northern and central regions in Morocco. These results should be taken into account for efficient control strategies and epidemiological surveillance of HIV –Leishmania spp. co-infection in Morocco.
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Affiliation(s)
- M Daoudi
- Laboratory of Ecology and Environment (URAC 32, CNRST; ERACNERS 06), Faculty of Sciences Semlalia, Cadi Ayyad University, Marrakesh, Morocco
| | - S Boussaa
- Laboratory of Ecology and Environment (URAC 32, CNRST; ERACNERS 06), Faculty of Sciences Semlalia, Cadi Ayyad University, Marrakesh, Morocco.,ISPITS-Higher Institute of Nursing and Health Techniques, Ministry of Health, Marrakesh, Morocco
| | - M Echchakery
- Laboratory of Ecology and Environment (URAC 32, CNRST; ERACNERS 06), Faculty of Sciences Semlalia, Cadi Ayyad University, Marrakesh, Morocco.,Laboratory of Medical Analysis, Regional Hospital Center of IbnZohr, Marrakesh, Morocco
| | - A Boumezzough
- Laboratory of Ecology and Environment (URAC 32, CNRST; ERACNERS 06), Faculty of Sciences Semlalia, Cadi Ayyad University, Marrakesh, Morocco
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15
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Lanza JS, Pomel S, Loiseau PM, Frézard F. Recent advances in amphotericin B delivery strategies for the treatment of leishmaniases. Expert Opin Drug Deliv 2019; 16:1063-1079. [DOI: 10.1080/17425247.2019.1659243] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Juliane S. Lanza
- Faculty of Pharmacy, Antiparasite Chemotherapy, UMR 8076 CNRS BioCIS, University Paris-Saclay, Chatenay-Malabry, France
| | - Sébastien Pomel
- Faculty of Pharmacy, Antiparasite Chemotherapy, UMR 8076 CNRS BioCIS, University Paris-Saclay, Chatenay-Malabry, France
| | - Philippe M. Loiseau
- Faculty of Pharmacy, Antiparasite Chemotherapy, UMR 8076 CNRS BioCIS, University Paris-Saclay, Chatenay-Malabry, France
| | - Frédéric Frézard
- Department of Physiology and Biophysics, Institute of Biological Sciences, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
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16
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Lindoso JAL, Moreira CHV, Cunha MA, Queiroz IT. Visceral leishmaniasis and HIV coinfection: current perspectives. HIV AIDS-RESEARCH AND PALLIATIVE CARE 2018; 10:193-201. [PMID: 30410407 PMCID: PMC6197215 DOI: 10.2147/hiv.s143929] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Visceral leishmaniasis (VL) is caused by Leishmania donovani and Leishmania infantum. The burden of VL is concentrated in tropical and subtropical areas; however, HIV infection has spread VL over a hyperendemic area. Several outcomes are observed as a result of VL–HIV coinfection. Impacts are observed in immunopathogenesis, clinical manifestation, diagnosis, and therapeutic response. Concerning clinical manifestation, typical and unusual manifestation has been observed during active VL in HIV-infected patient, as well as alteration in immunoresponse, inducing greater immunosuppression by low CD4 T-lymphocyte count or even by induction of immunoactivation, with cell senescence. Serological diagnosis of VL in the HIV-infected is poor, due to low humoral response, characterized by antibody production, so parasitological methods are more recommended. Another important and even more challenging point is the definition of the best therapeutic regimen for VL in HIV-coinfected patients, because in this population there is greater failure and consequently higher mortality. The challenge of better understanding immunopathogenesis in order to obtain more effective therapies is one of the crucial points to be developed. The combination of drugs and the use of secondary prophylaxis associated with highly active antiretroviral therapy may be the best tool for treatment of HIV coinfection. Some derivatives from natural sources have action against Leishmania; however, studies have been limited to in vitro evaluation, without clinical trials.
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Affiliation(s)
- José Angelo Lauletta Lindoso
- Instituto de Infectologia Emilio Ribas, São Paulo, Brazil, .,Nucleo de Medicina Tropical, Universidade de Brasília, Brasília, Brazil, .,Laboratorio de Soroepidemiologia, Institutode Medicina Tropical, Universidade de São Paulo, São Paulo, Brazil,
| | - Carlos Henrique Valente Moreira
- Instituto de Infectologia Emilio Ribas, São Paulo, Brazil, .,Laboratorio de Parasitologia, Instituto de Medicina Tropical, Universidade de São Paulo, São Paulo, Brazil
| | - Mirella Alves Cunha
- Departamento de Infectologia, Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | - Igor Thiago Queiroz
- Universidade Potiguar (UnP), Laureate International Universities, Natal, Brazil.,Hospital Giselda Trigueiro (SESAP/RN), Natal, Brazil
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Maritati M, Trentini A, Michel G, Bellini T, Almugadam S, Hanau S, Govoni M, Marty P, Contini C. Subclinical Leishmania infection in patients with rheumatic diseases under biological drugs. Infection 2018; 46:801-809. [PMID: 30097989 DOI: 10.1007/s15010-018-1189-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 07/31/2018] [Indexed: 12/22/2022]
Abstract
PURPOSE Climate changes and immunosuppression are influencing the spread of leishmaniasis and re-emergence in Northern Italy, respectively. We evaluated the prevalence of subclinical leishmaniasis in patients from a Northern Italian region with chronic inflammatory rheumatism (CIRD) receiving biological drugs (BD) and correlated it to the area of residence. METHODS DNA from PBMC of patients affected by CIRD treated with either BD for at least 5 years (Group A) or other immunosuppressive drugs (Group B) was investigated by a qPCR for Leishmania infantum kDNA and compared to healthy subjects (Group C). Variables such as sex and age, rural areas, dog ownership, type of BD administered and association between BD and steroids, were evaluated by statistical analysis. RESULTS A higher proportion of L. infantum DNA positivity was found in Group A than in Group C (p < 0.05), while no parasite DNA was detected in Group B. In Group A, 18/50 patients (36%) had higher rates of parasite DNA (from 1 to 136 to 1.000.000 copies/ml) than Group C (from 1 to 10 copies/ml). 14/18 (77.7%) of positive patients from Group A lived in rural areas, but no statistical differences occurred in relation to dog ownership or BD type (p < 0.0003). CONCLUSIONS We can speculate that exposure to rural areas appears to be a factor closely linked with the risk of developing Leishmania subclinical infection. A screening with molecular methods in patients with CIRD treated with BD living in these areas and monitoring Leishmania DNA during such therapies, would be mandatory to prevent delay in diagnosis should VL symptoms appear.
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Affiliation(s)
- Martina Maritati
- Section of Infectious Diseases and Dermatology, Department of Medical Sciences, University of Ferrara, 44124, Ferrara, Italy
| | - Alessandro Trentini
- Section of Medical Biochemistry, Molecular Biology and Genetics, Department of Biomedical and Specialist Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - Gregory Michel
- INSERM, U1065, Centre Méditerranéen de Médecine Moléculaire, C3M, Toxines Microbiennes dans la Relation Hôte-Pathogènes, 06204, Nice, France.,Faculté de Médecine, Université de Nice Sophia Antipolis, Nice, France
| | - Tiziana Bellini
- Section of Medical Biochemistry, Molecular Biology and Genetics, Department of Biomedical and Specialist Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - Shawgi Almugadam
- Section of Medical Biochemistry, Molecular Biology and Genetics, Department of Biomedical and Specialist Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - Stefania Hanau
- Section of Medical Biochemistry, Molecular Biology and Genetics, Department of Biomedical and Specialist Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - Marcello Govoni
- Section of Hematology and Rheumatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Pierre Marty
- INSERM, U1065, Centre Méditerranéen de Médecine Moléculaire, C3M, Toxines Microbiennes dans la Relation Hôte-Pathogènes, 06204, Nice, France.,Faculté de Médecine, Université de Nice Sophia Antipolis, Nice, France.,Parasitologie-Mycologie, Centre Hospitalier Universitaire l'Archet, Université Côte d'Azur, CS 23079, 06202, Nice, France
| | - Carlo Contini
- Section of Infectious Diseases and Dermatology, Department of Medical Sciences, University of Ferrara, 44124, Ferrara, Italy.
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