title: Screening for subclinical Leishmania infection in HIV-infected patients living in eastern Spain.
abstract: BACKGROUND
  We anticipated that patients with HIV infection living in endemic areas were at greater risk of infection which can reactivate due to immunosuppression; therefore, we analyzed the prevalence of latent Leishmania infantum infection in patients infected with HIV.
  
  
  METHODS
  A total of 179 patients with HIV infection were screened for the presence of anti-Leishmania antibodies using indirect immunofluorescent antibody test (IFAT) (Leishmania-spot IF; bioMérieux, Marcy l'Etoile, France). All patients were followed up for at least 1 year. The primary end-point was to confirm the presence of Leishmania infection.
  
  
  RESULTS
  Significant titer of antibodies to Leishmania was detected in six (3%; 95% confidence interval: 0.5-5.5%) asymptomatic patients. Two of them had visceral leishmaniasis that was confirmed by parasite visualization in clinical samples, the presence of Leishmania promastigotes in Novy-MacNeal-Nicolle culture, polymerase chain reaction (PCR)-based methods, and/or urinary antigen test. Among 173 patients with indirect immunofluorescent antibody test below 1:40, one HIV-infected patient severely immunosuppressed, confirmed negative by IFAT, was diagnosed of visceral leishmaniasis.
  
  
  CONCLUSIONS
  The use of indirect immunofluorescent antibody test for Leishmania screening is not justified in asymptomatic patients with HIV infection living in endemic areas due to the small rate of significant antibody titer and the low frequency of clinical disease.
authors.forename: Javier
authors.initials: J
authors.lastname: Ena
authors.forename: Francisco
authors.initials: F
authors.lastname: Pasquau
authors.forename: María
authors.initials: M
authors.lastname: del Mar López-Perezagua
authors.forename: Carmen
authors.initials: C
authors.lastname: Martinez-Peinado
authors.forename: Francisco
authors.initials: F
authors.lastname: Arjona
mesh_terms: D000328:Adult; D000913:Antibodies, Protozoan / Q000097:blood*; D058345:Asymptomatic Infections / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D005500:Follow-Up Studies; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D018314:Leishmania infantum / Q000276:immunology* / Q000302:isolation & purification; D007898:Leishmaniasis, Visceral / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016036:Seroepidemiologic Studies; D013030:Spain / Q000453:epidemiology
chemical_list: D000913:Antibodies, Protozoan
keywords: HIV-1 infection; Leishmania,; Screening,; Serology,