Frequency of Leishmania spp. infection among HIV-infected patients living in an urban area in Brazil: a cross-sectional study
Abstract Background: There is little information about the frequency of Leishmaniainfection in asymptomatic HIV infected individuals and about the performance of laboratory diagnostic methods in coinfected patients in Latin America. The main objective of this study is to evaluate the frequency of Leishmaniaspp. infection in HIV infected patients living in an urban area from Brazil. Methods: To detect Leishmaniainfection, were performed diagnostic tests to detection of antibodies anti-Leishmania(ELISA using Leptomonas seymouriantigens; ELISA using rk39 antigens; ELISA using rK28 antigens; indirect fluorescent-antibody test (IFAT); direct agglutination test (DAT) and detection of LeishmaniaDNA by polymerase chain reaction (PCR) with the target genes kDNA and ITS-1. Results: Frequency, considering at least one positive test, was 15%. For ELISA using Leptomonasantigens and IFAT, there was an association between CD4+ T-lymphocyte counts and test positivity, with a higher positivity of these tests in more immunosuppressed patients (T CD4+ cells count < 200/mm3). Conclusions: According to our data, there was a high prevalence of Leishmaniaspp. in this population living with HIV. Although there is the possibility of cross-reaction, some tests considered highly specific for the diagnosis of Leishmania infection were positive. There was also an association between the positivity of some tests studied and lower values of T CD4+ lymphocytes.