title: Prevalence of Leishmania infection in adult HIV/AIDS patients treated in a tertiary-level care center in Brasilia, Federal District, Brazil.
abstract: In order to estimate the magnitude of Leishmania/HIV co-infection, patients with HIV/AIDS at the Brasilia University Hospital, DF, Brazil were used as subjects in a cross-sectional study. One hundred and sixty-three patients were enrolled, seven of whom had visceral leishmaniasis (VL). One hundred and twelve patients (68.7%) were men; 155 (95.1%) had been exposed to HIV infection through unprotected sex. The median age was 37 years (range: 20-74) and the median CD4+ lymphocyte count was 314 cells/microl (range: 2-1600). Symptomatic patients underwent bone marrow evaluations through direct examination of Giemsa-stained films, parasite culture and PCR assay. Blood samples were evaluated by means of an indirect immunofluorescent antibody test (IFAT), an ELISA using a soluble antigen of L. chagasi (ELISA), an ELISA with the rK39 antigen (ELISA-rK39) and a PCR targeted to the kDNA region and to the internal transcribed spacer 1 of the rDNA gene. The proportion of positive results was 2.4% for the IFAT, 12.3% for the ELISA and 4.9% for the rK39 tests. The estimated prevalence was 16%. The PCR in the blood was positive in three patients (1.8%). The prevalence of Leishmania spp. infection is high among HIV patients attending this Brazilian center suggesting that they should be routinely investigated for VL infection.
authors.affiliation: Laboratório de Leishmanioses do Núcleo de Medicina Tropical, Universidade de Brasília, Asa Norte, Brasília, DF, Brazil.
authors.forename: César O
authors.initials: CO
authors.lastname: Carranza-Tamayo
authors.forename: Tália Santana Machado
authors.initials: TS
authors.lastname: de Assis
authors.forename: Ana Teresa Basílio
authors.initials: AT
authors.lastname: Neri
authors.forename: Elisa
authors.initials: E
authors.lastname: Cupolillo
authors.forename: Ana
authors.initials: A
authors.lastname: Rabello
authors.forename: Gustavo Adolfo Sierra
authors.initials: GA
authors.lastname: Romero
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology; D000328:Adult; D000368:Aged; D001938:Brazil / Q000453:epidemiology; D015496:CD4-Positive T-Lymphocytes; D003430:Cross-Sectional Studies; D042241:Early Diagnosis; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D015497:HIV-1 / Q000235:genetics / Q000276:immunology; D006801:Humans; D007898:Leishmaniasis, Visceral / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D047568:Unsafe Sex / Q000706:statistics & numerical data; D055815:Young Adult