title: Diagnosing visceral leishmaniasis and HIV/AIDS co-infection: a case series study in Pernambuco, Brazil.
abstract: HIV/AIDS-associated visceral leishmaniasis may display the characteristics of an aggressive disease or without specific symptoms at all, thus making diagnosis difficult. The present study describes the results of diagnostic tests applied to a series of suspected VL cases in HIV-infected/AIDS patients admitted in referral hospitals in Pernambuco, Brazil. From a total of 14 eligible patients with cytopenias and/or fever of an unknown etiology, and indication of bone marrow aspirate, 10 patients were selected for inclusion in the study. Diagnosis was confirmed by the following examinations: Leishmania detection in bone marrow aspirate, direct agglutination test, indirect immunofluorescence, rK39 dipstick test, polymerase chain reaction and latex agglutination test. Five out of the ten patients were diagnosed with co-infection. A positive direct agglutination test was recorded for all five co-infected patients, the Leishmania detection and latex agglutination tests were positive in four patients, the rK39 dipstick test in three, the indirect immunofluorescence in two and a positive polymerase chain reaction was recorded for one patient. This series of cases was the first to be conducted in Brazil using this set of tests in order to detect co-infection. However, no consensus has thus far been reached regarding the most appropriate examination for the screening and monitoring of this group of patients.
authors.affiliation: Universidade de Pernambuco, Boa Vista, Recife, PE, Brazil. aracelecavalcanti@hotmail.com
authors.forename: Aracele Tenório de Almeida e
authors.initials: AT
authors.lastname: Cavalcanti
authors.forename: Zulma
authors.initials: Z
authors.lastname: Medeiros
authors.forename: Fábio
authors.initials: F
authors.lastname: Lopes
authors.forename: Luiz Dias de
authors.initials: LD
authors.lastname: Andrade
authors.forename: Valéria de Melo
authors.initials: Vde M
authors.lastname: Ferreira
authors.forename: Vera
authors.initials: V
authors.lastname: Magalhães
authors.forename: Demócrito de Barros
authors.initials: Dde B
authors.lastname: Miranda-Filho
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis*; D000328:Adult; D060085:Coinfection / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007898:Leishmaniasis, Visceral / Q000175:diagnosis*; D008297:Male; D016133:Polymerase Chain Reaction; D012680:Sensitivity and Specificity; D012698:Serologic Tests / Q000379:methods*