Your browser doesn't support javascript.
loading
Exploring prognosis in chronic relapsing visceral leishmaniasis among HIV-infected patients: Circulating Leishmania DNA.
Cota, Gláucia Fernandes; de Sousa, Marcos Roberto; de Assis, Tália Santana Machado; Pinto, Bruna Fernandes; Rabello, Ana.
Afiliación
  • Cota GF; Clinical Research and Public Policy and Parasitic Diseases, Centro de Pesquisas René Rachou - Fundação Oswaldo Cruz (Fiocruz), Belo Horizonte, Minas Gerais, Brazil. Electronic address: cota@cpqrr.fiocruz.br.
  • de Sousa MR; Universidade Federal de Minas Gerais, Post-Graduate Program in Adult Health Sciences, Belo Horizonte, Minas Gerais, Brazil.
  • de Assis TSM; Clinical Research and Public Policy and Parasitic Diseases, Centro de Pesquisas René Rachou - Fundação Oswaldo Cruz (Fiocruz), Belo Horizonte, Minas Gerais, Brazil.
  • Pinto BF; Clinical Research and Public Policy and Parasitic Diseases, Centro de Pesquisas René Rachou - Fundação Oswaldo Cruz (Fiocruz), Belo Horizonte, Minas Gerais, Brazil.
  • Rabello A; Clinical Research and Public Policy and Parasitic Diseases, Centro de Pesquisas René Rachou - Fundação Oswaldo Cruz (Fiocruz), Belo Horizonte, Minas Gerais, Brazil.
Acta Trop ; 172: 186-191, 2017 Aug.
Article en En | MEDLINE | ID: mdl-28501450
BACKGROUND: Visceral leishmaniasis (VL) affecting HIV-infected patients is considered a challenging condition because of its high mortality and relapse rates. The approach of this condition is still surrounded by many uncertainties, especially regarding the criteria to institute and discontinue secondary prophylaxis for VL. The aim of this study was to evaluate the Leishmania parasitism kinetic assessed by polymerase chain reaction (PCR) as a possible tool in the prognostic assessment in a context in which patients are receiving highly active antiretroviral therapy and secondary prophylaxis. METHODS: A prospective observation of Leishmania-HIV-co infected patients was performed and two groups with distinct clinical prognosis unpredicted by their CD4 count at the moment of VL diagnosis and not related to their HIV load control were confirmed. RESULTS: Relapsing (R) and non-relapsing (NR) patients had similar antiviral therapy use rates, CD4 lymphocyte count medians and HIV load levels at VL-diagnosis. At the 12-month follow-up, R-patients presented a significantly lower CD4 lymphocyte count than NR-patients, without difference in HIV load control. The time between HIV and VL diagnoses was longer in the R than NR-group. Comparison between Kaplan-Meier relapse-free survival curves (time to relapse) using a log rank test showed that patients presenting circulating Leishmania DNA had a significantly higher risk of clinical VL relapse within 4 months after a positive test (p=0.001). CONCLUSIONS: These results reinforce that a negative PCR could be a useful tool to support prophylaxis interruption among patients with CD4 counts above 200cells/mm3 and that a positive PCR suggests imminent VL relapse.
Asunto(s)
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones por VIH / Coinfección / Leishmaniasis Visceral Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Acta Trop Año: 2017 Tipo del documento: Article Pais de publicación: Países Bajos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones por VIH / Coinfección / Leishmaniasis Visceral Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Acta Trop Año: 2017 Tipo del documento: Article Pais de publicación: Países Bajos