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Am J Trop Med Hyg. 2013 Jul;89(1):105-10. doi: 10.4269/ajtmh.12-0527. Epub 2013 Apr 29.

Ultrasensitive real-time PCR for the clinical management of visceral leishmaniasis in HIV-Infected patients.

Author information

1
Infectious Disease Department, Universitat Autònoma de Barcelona, Barcelona, Spain. imolina@vhebron.net

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.

PMID:
23629932
PMCID:
PMC3748463
DOI:
10.4269/ajtmh.12-0527
[Indexed for MEDLINE]
Free PMC Article

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