title: First report of Babesia divergens infection in an HIV patient.
abstract: Human babesiosis is a zoonosis primarily transmitted through Ixodes ticks and alternatively by routes such as blood transfusions from asymptomatic donors. We report the first case of human babesiosis caused by Babesia divergens in a patient with HIV. This study also focuses on elucidating the possible transmission route of infection in this patient, who received numerous blood transfusions but showed patent symptoms only after splenectomy. A battery of detection tools along with a novel Western-Blot Assay and Enzyme Linked Immunosorbent Assay using the major surface protein of B. divergens (Bd37) as a target were used to evaluate the presence of B. divergens or antibodies against the parasite in samples from the patient and the blood donors involved in this case. A retrospective study of the humoral status against the parasite revealed B. divergens IgG antibodies in one of the implicated donors, but also showed that the patient had been already exposed to the parasite before any transfusion. Thus, this analysis of natural and transfusion transmission routes suggests a pre-existing subclinical babesiosis in the patient.
authors: Servicio de Parasitología, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain. Electronic address: lmgonzal@isciii.es.
authors: Luis M
authors: LM
authors: González
authors: Cruz Roja Española, Centro de Transfusión, Madrid, Spain. Electronic address: emmacastroizaguirre@gmail.com.
authors: Emma
authors: E
authors: Castro
authors: Blood Borne Parasites Department, Lindsley Kimball Research Institute New York Blood Center, New York, New York, USA. Electronic address: CLobo@NYBloodCenter.org.
authors: Cheryl A
authors: CA
authors: Lobo
authors: Centro de Transfusión de la Comunidad de Madrid, Madrid, Spain. Electronic address: alberto.richart@salud.madrid.org.
authors: Alberto
authors: A
authors: Richart
authors: Servicio de Parasitología, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain. Electronic address: rramiro@isciii.es.
authors: Raquel
authors: R
authors: Ramiro
authors: Unidad de Microscopía Electrónica y Confocal, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain. Electronic address: fgonzalezc@isciii.es.
authors: Fernando
authors: F
authors: González-Camacho
authors: Unidad de Microscopía Electrónica y Confocal, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain. Electronic address: dluque@isciii.es.
authors: Daniel
authors: D
authors: Luque
authors: Departamento de Microbiología, Hospital Universitario San Carlos, Madrid, Spain. Electronic address: aurelio.velasco@salud.madrid.org.
authors: Aurelio C
authors: AC
authors: Velasco
authors: Servicio de Parasitología, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain. Electronic address: estrella.montero@isciii.es.
authors: Estrella
authors: E
authors: Montero
mesh_terms: D000328:Adult; D001403:Babesia / Q000302:isolation & purification*; D001404:Babesiosis / Q000175:diagnosis* / Q000209:etiology; D001782:Blood Donors; D001803:Blood Transfusion; D060085:Coinfection / Q000175:diagnosis*; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D013156:Splenectomy
keywords: Babesia divergens; HIV; babesiosis; blood transfusion; patient; transmission route