Cryptic Leishmania infantum infection in Italian HIV infected patients.
BACKGROUND
Visceral leishmaniasis (VL) is a protozoan diseases caused in Europe by Leishmania (L.) infantum. Asymptomatic Leishmania infection is more frequent than clinically apparent disease. Among HIV infected patients the risk of clinical VL is increased due to immunosuppression, which can reactivate a latent infection. The aims of our study were to assess the prevalence of asymptomatic L. infantum infection in HIV infected patients and to study a possible correlation between Leishmania parasitemia and HIV infection markers.


METHODS
One hundred and forty-five HIV infected patients were screened for the presence of anti-Leishmania antibodies and L. infantum DNA in peripheral blood. Statistical analysis was carried out by using a univariate regression analysis.


RESULTS
Antibodies to L. infantum were detected in 1.4% of patients. L. infantum DNA was detected in 16.5% of patients. Significant association for PCR-Leishmania levels with plasma viral load was documented (p = 0.0001).


CONCLUSIONS
In our area a considerable proportion of HIV infected patients are asymptomatic carriers of L. infantum infection. A relationship between high HIV viral load and high parasitemic burden, possibly related to a higher risk of developing symptomatic disease, is suggested. PCR could be used for periodic screening of HIV patients to individuate those with higher risk of reactivation of L. infantum infection.
Colomba
Claudia
C
Dipartimento di Scienze per la Promozione della Salute, Sezione di Malattie Infettive, Università di Palermo, Palermo, Italy. claudia.colomba@libero.it
Saporito
Laura
L
Vitale
Fabrizio
F
Reale
Stefano
S
Vitale
Giustina
G
Casuccio
Alessandra
A
Tolomeo
Manlio
M
Maranto
Daniela
D
Rubino
Raffaella
R
Di Carlo
Paola
P
Titone
Lucina
L
D000328:Adult; D000368:Aged; D000913:Antibodies, Protozoan / Q000097:blood; D002353:Carrier State; D016054:DNA, Protozoan / Q000097:blood; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000469:parasitology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007558:Italy / Q000453:epidemiology; D018314:Leishmania infantum / Q000276:immunology / Q000302:isolation & purification*; D007898:Leishmaniasis, Visceral / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D018512:Parasitemia / Q000453:epidemiology; D015995:Prevalence; D012044:Regression Analysis; D055815:Young Adult
D000913:Antibodies, Protozoan; D016054:DNA, Protozoan; D007074:Immunoglobulin G