Cryptic Leishmania infantum infection in Italian HIV infected patients
1 Dipartimento di Scienze per la Promozione della Salute, Sezione di Malattie Infettive, Università di Palermo, Palermo, Italy
2 Centro di Referenza Nazionale per le Leishmaniosi (CReNaL), Istituto Zooprofilattico Sperimentale della Sicilia, Palermo, Italy
3 Dipartimento di Medicina Clinica e delle Patologie Emergenti, Azienda Ospedaliera Universitaria Policlinico, Palermo, Italy
4 Dipartimento di Neuroscienze Cliniche, Università di Palermo, Palermo, Italy
BMC Infectious Diseases 2009, 9:199 doi:10.1186/1471-2334-9-199Published: 10 December 2009
Visceral leishmaniasis (VL) is a protozoan diseases caused in Europe by Leishmania (L.) infantum. Asymptomatic Leishmania infection is more frequent than clinically apparent disease. Among HIV infected patients the risk of clinical VL is increased due to immunosuppression, which can reactivate a latent infection. The aims of our study were to assess the prevalence of asymptomatic L. infantum infection in HIV infected patients and to study a possible correlation between Leishmania parasitemia and HIV infection markers.
One hundred and forty-five HIV infected patients were screened for the presence of anti-Leishmania antibodies and L. infantum DNA in peripheral blood. Statistical analysis was carried out by using a univariate regression analysis.
Antibodies to L. infantum were detected in 1.4% of patients. L. infantum DNA was detected in 16.5% of patients. Significant association for PCR-Leishmania levels with plasma viral load was documented (p = 0.0001).
In our area a considerable proportion of HIV infected patients are asymptomatic carriers of L. infantum infection. A relationship between high HIV viral load and high parasitemic burden, possibly related to a higher risk of developing symptomatic disease, is suggested. PCR could be used for periodic screening of HIV patients to individuate those with higher risk of reactivation of L. infantum infection.