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Visceral leishmaniasis

About: Visceral leishmaniasis is a research topic. Over the lifetime, 7486 publications have been published within this topic receiving 184865 citations. The topic is also known as: Kala-Azar & viscus leishmaniasis.


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Journal ArticleDOI
TL;DR: IFT and TRALd presented the best performance to diagnose classic cases of visceral leishmaniasis in an endemic area and differences in the positivity of the tests used, together with the low agreement between results, do not permit to select the best test for the diagnosis of asymptomatic Leishmania infection.
Abstract: Serologic tests have been widely used for the diagnosis of asymptomatic visceral leishmaniasis. This study evaluated five serologic tests used for the diagnosis of asymptomatic infection: enzyme-linked immunosorbent assay (ELISA) using promastigote antigen (ELISAp), ELISA using recombinant K39 (ELISA rK39), and K26 (ELISA rK26) antigens, an indirect immunofluorescence test using Leishmania (Leishmania) amazonensis promastigote antigen (IIFT), and an immunochromatographic test using rK39 antigen (TRALd). As a reference regarding the performance of the tests, patients with classic visceral leishmaniasis originating from Minas Gerais, Brazil (N = 36), were defined as the positive group and samples of healthy individuals from nonendemic areas (Argentina) (N = 127) were used as negative controls. Patients with other diseases such as cutaneous leishmaniasis (N = 53) and malaria (N = 56) were also studied to evaluate the chance of cross-reactivity in these tests. Finally, subjects from an area endemic for visceral leishmaniasis in Brazil (Porteirinha, northern Minas Gerais) (N = 1241) were screened for asymptomatic infection with Leishmania and Chagas disease. The sensitivity of the serologic tests was 50% (18/36), 66.7% (24/36), 69.4% (25/36), 83.3% (30/36), and 88.9% (32/36) for ELISAp, ELISA rK26, ELISA rK39, IIFT, and TRALd, respectively. Specificity, calculated using the truly negative group, was 96% (122/127) for TRALd, 97.6% (124/127) for ELISAp and IIFT, and 100% (127/127) for ELISA rK39 and rK26. Positivity in at least one test employing recombinant antigen was observed in 24 (45%) patients with cutaneous leishmaniasis and 47 (82.4%) with malaria. In the visceral leishmaniasis-endemic area, the positivity of the serologic tests ranged from 3.9% to 37.5%. The enzyme-linked immunosorbent assay (ELISA) tests using recombinant antigens were more frequently positive in subjects with a history of exposure to human or canine visceral leishmaniasis (ELISArK39: 14.6% [149/1017] versus 37.5% [84/224]; ELISA rK26: 12.7% [129/1017] versus 21.4% [48/224], P < 0.001 for both). Kappa agreement was low, with a maximum value of 0.449 between ELISAp and IIFT. In addition, among the 112 IIFT-positive subjects, 75 (67%) also presented positive serology for Chagas disease. In conclusion, IIFT and TRALd presented the best performance to diagnose classic cases of visceral leishmaniasis in an endemic area. Cross-reactivity of the tests with Chagas disease, cutaneous leishmaniasis, and malaria should be taken into account. However, the differences in the positivity of the tests used, together with the low agreement between results, do not permit to select the best test for the diagnosis of asymptomatic Leishmania infection.

76 citations

Journal ArticleDOI
TL;DR: In those receiving HAART, relapses of the VL often occurred despite increasing CD4+ cell counts and undetectable HIV loads, indicating that successful treatment of the viral infection is insufficient to prevent the relapse of the leishmaniasis.
Abstract: Clinicians in Madrid have been observing and treating HIV-positive patients with visceral leishmaniasis (VL) for over a decade. As their records cover some of the co-infection cases that occurred before and after highly active antiretroviral therapy (HAART) was introduced into Spain, retrospective analysis of the records has allowed some of the eVects of HAART on local VL to be determined. Encouragingly, HAART appears to have decreased the annual incidence of VL among local AIDS cases, from 4.81 cases/100 to just 0.8 case/100 ( P 200 cells/ml can be maintained using HAART. VL also seems to hamper the immunological recovery of the HIV-positive, although HAART appears to have little e Vect on the clinical manifestations of VL. VISCERAL LEISHMANIASIS IN THE 2%‐ 9% of AIDS patients will develop VL (WHO, 1999). During the 1990s, most HIV-INFECTED: INCIDENCE (50%‐ 60%) of the adult VL cases recorded in Spain were co-infected with HIV, and up Human infection with Leishmania infantum , to 17% of Spanish HIV-positive patients the cause of visceral leishmaniasis (VL) in with non-viral fever were found to be su VerEurope, is quite common in the countries ing from VL (Miralles et al., 1995). The that lie in Mediterranean basin, although it great majority of the new cases of VL is not always symptomatic. In the south of detected in Spain now occur in patients Spain, for example, leishmanial amastigotes with late-stage HIV infection (77%‐ 90%, can be found in 6% of bone-marrow biopsies 7%‐ 22% and only 0%‐ 3% of such cases collected from asymptomatic HIV-positive having 500 CD4+ patients, although all such patients will cells/ml, respectively), and 42%‐ 72% meet probably develop clinical VL (De la Rosa the standard criteria for AIDS before or et al., 2001). In southern Europe generally, during their e rst episode of leishmaniasis

76 citations

Journal ArticleDOI
TL;DR: Treatment of kala azar in immunocompromised host is in satisfactory and new drugs or strategies are urgently needed.

76 citations

Journal ArticleDOI
TL;DR: Results indicate that a higher quantity of Leishmania DNA was found in the lymph nodes of dogs characterized by maximum clinical score, indicating the presence of a positive relationship betweenLeishmania load and clinical manifestations in dogs showing a severe clinical form of leishmaniasis.

76 citations


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Performance
Metrics
No. of papers in the topic in previous years
YearPapers
2023192
2022442
2021269
2020285
2019286
2018253