A cloned antigen (recombinant K39) of Leishmania chagasi diagnostic for visceral leishmaniasis in human immunodeficiency virus type 1 patients and a prognostic indicator for monitoring patients undergoing drug therapy.
Serologic assays using crude antigens for the diagnosis of visceral leishmaniasis in human immunodeficiency virus type 1 (HIV)-seropositive patients have been shown to lack sensitivity and specificity, particularly in AIDS patients. Antibodies to a cloned antigen, recombinant (r) K39, of Leishmania chagasi are specific for members of the Leishmania donovani complex and have been shown to indicate active disease in immunocompetent persons. This study demonstrated that antibodies to rK39 were also detectable in HIV-seropositive patients coinfected with Leishmania infantum. Furthermore, the rK39 ELISA was more sensitive than an IFA for detecting L. infantum infections in patients with AIDS. In addition, antibody titers to rK39 in HIV-negative patients infected with L. infantum or L. chagasi declined during treatment with meglumine antimoniate or liposomal amphotericin B. In contrast, most patients who clinically relapsed showed increased antibody titers to rK39. These data demonstrate the diagnostic and prognostic utility of rK39 in detecting active visceral leishmaniasis.
Houghton
R L
RL
Corixa Corp., Seattle, Washington 98104, USA. houghton@corixa.com
Petrescu
M
M
Benson
D R
DR
Skeiky
Y A
YA
Scalone
A
A
Badaró
R
R
Reed
S G
SG
Gradoni
L
L
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis* / Q000469:parasitology; D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy*; D000328:Adult; D000818:Animals; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D000913:Antibodies, Protozoan / Q000097:blood*; D000917:Antibody Formation; D000953:Antigens, Protozoan / Q000276:immunology; D002648:Child; D004797:Enzyme-Linked Immunosorbent Assay; D006679:HIV Seropositivity / Q000188:drug therapy*; D015497:HIV-1 / Q000302:isolation & purification*; D006801:Humans; D018314:Leishmania infantum / Q000302:isolation & purification*; D007898:Leishmaniasis, Visceral / Q000150:complications* / Q000175:diagnosis; D015166:Monitoring, Immunologic; D011379:Prognosis; D015800:Protozoan Proteins / Q000276:immunology*; D011994:Recombinant Proteins / Q000276:immunology; D012008:Recurrence
D019380:Anti-HIV Agents; D000913:Antibodies, Protozoan; D000953:Antigens, Protozoan; D015800:Protozoan Proteins; D011994:Recombinant Proteins; C079253:K39 antigen, Leishmania