title: Comparison of parasitological, serological, and molecular tests for visceral leishmaniasis in HIV-infected patients: a cross-sectional delayed-type study.
abstract: The aim of this study was to evaluate the accuracy of invasive and non-invasive tests for diagnosis of visceral leishmaniasis (VL) in a large series of human immunodeficiency virus (HIV)-infected patients. In this delayed-type cross-sectional study, 113 HIV-infected symptomatic patients were evaluated by an adjudication committee after clinical follow-up to establish the presence or absence of VL as the target condition (reference test). The index tests were recombinant K39 antigen-based immunochromatographic test (rK39), indirect fluorescent antibody test (IFAT), prototype kit of direct agglutination test (DAT-LPC), and real-time polymerase chain reaction (qPCR) in peripheral blood. Compared with parasitological test and adjudication committee diagnosis or latent class model analyses, IFAT and rk39 dipstick test presented the lowest sensitivity. DAT-LPC exhibited good overall performance, and there was no statistical difference between DAT-LPC and qPCR diagnosis accuracy. Real-time PCR emerges as a less invasive alternative to parasitological examination for confirmation of cases not identified by DAT.
authors.affiliation: Eduardo de Menezes Hospital, Fundação Hospitalar do Estado de Minas Gerais (FHEMIG), Belo Horizonte, Minas Gerais, Brazil. glauciacota@uol.com.br
authors.forename: Gláucia Fernandes
authors.initials: GF
authors.lastname: Cota
authors.forename: Marcos Roberto
authors.initials: MR
authors.lastname: de Sousa
authors.forename: Betânia Mara
authors.initials: BM
authors.lastname: de Freitas Nogueira
authors.forename: Luciana Inácia
authors.initials: LI
authors.lastname: Gomes
authors.forename: Edward
authors.initials: E
authors.lastname: Oliveira
authors.forename: Tália Santana Machado
authors.initials: TS
authors.lastname: Assis
authors.forename: Andréa Laender Pessoa
authors.initials: AL
authors.lastname: de Mendonça
authors.forename: Bruna Fernandes
authors.initials: BF
authors.lastname: Pinto
authors.forename: Juliana Wilke
authors.initials: JW
authors.lastname: Saliba
authors.forename: Ana
authors.initials: A
authors.lastname: Rabello
mesh_terms: D000328:Adult; D000372:Agglutination Tests / Q000379:methods*; D000913:Antibodies, Protozoan / Q000097:blood; D060085:Coinfection / Q000175:diagnosis / Q000469:parasitology / Q000821:virology; D003430:Cross-Sectional Studies; D016054:DNA, Protozoan / Q000302:isolation & purification; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect / Q000379:methods*; D015658:HIV Infections / Q000469:parasitology; D006801:Humans; D007891:Leishmania / Q000302:isolation & purification; D007898:Leishmaniasis, Visceral / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D060888:Real-Time Polymerase Chain Reaction / Q000379:methods*; D012680:Sensitivity and Specificity
chemical_list: D000913:Antibodies, Protozoan; D016054:DNA, Protozoan