title: Ultrasensitive real-time PCR for the clinical management of visceral leishmaniasis in HIV-Infected patients.
abstract: Molecular methods have been proposed as an alternative tool for the diagnosis of visceral leishmaniasis (VL), but no data are available regarding use for monitoring clinical outcome. A prospective cohort study of human immunodeficiency virus-(HIV) and VL-coinfected patients was conducted in a university-affiliated hospital in Barcelona, Spain. Leishmania parasite load was monitored using a real-time polymerase chain reaction (PCR) at baseline and every 3 months. Cutoff values for PCR were determined using receiver operating characteristic (ROC) curves. Overall, 37 episodes were analyzed, and 25 of these episodes were considered as relapsing episodes. A significant decrease of parasite load measured 3 months after treatment could predict the clinical evolution of VL. A parasite load over 0.9 parasites/mL measured 12 months after treatment could predicts relapse with a sensitivity of 100% and a specificity of 90.9%. Monitoring parasite load by an ultrasensitive quantitative Leishmania PCR is useful to predict the risk of relapse after a VL episode in HIV-infected patients.
authors: Infectious Disease Department, Universitat Autònoma de Barcelona, Barcelona, Spain. imolina@vhebron.net
authors: Israel
authors: I
authors: Molina
authors: Roser
authors: R
authors: Fisa
authors: Cristina
authors: C
authors: Riera
authors: Vicenç
authors: V
authors: Falcó
authors: Aleix
authors: A
authors: Elizalde
authors: Fernando
authors: F
authors: Salvador
authors: Manuel
authors: M
authors: Crespo
authors: Adrian
authors: A
authors: Curran
authors: Paulo
authors: P
authors: López-Chejade
authors: Silvia
authors: S
authors: Tebar
authors: Santiago
authors: S
authors: Pérez-Hoyos
authors: Esteban
authors: E
authors: Ribera
authors: Albert
authors: A
authors: Pahissa
mesh_terms: D000328:Adult; D000666:Amphotericin B / Q000008:administration & dosage / Q000627:therapeutic use; D000981:Antiprotozoal Agents / Q000008:administration & dosage / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D060085:Coinfection / Q000175:diagnosis / Q000469:parasitology / Q000821:virology; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000469:parasitology; D006801:Humans; D007898:Leishmaniasis, Visceral / Q000150:complications / Q000175:diagnosis* / Q000821:virology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012372:ROC Curve; D060888:Real-Time Polymerase Chain Reaction / Q000379:methods*; D012008:Recurrence
chemical_list: D000981:Antiprotozoal Agents; C068538:liposomal amphotericin B; D000666:Amphotericin B
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