Visceral Leishmaniasis in Hospitalized HIV-Infected Patients in Pernambuco, Brazil

被引:13
|
作者
Guedes, Diego Lins [1 ,2 ]
Medeiros, Zulma [2 ,3 ]
da Silva, Elis Dionisio [2 ]
Martins de Vasconcelos, Audrey Violeta [4 ]
da Silva, Mariana Santana [2 ]
Lopes da Silva, Maria Almerice [2 ]
Ramos de Araujo, Paulo Sergio [2 ]
Miranda-Filho, Democrito de Barros [5 ]
机构
[1] Univ Fed Pernambuco, Nucleo Ciencias Vida, Curso Med, Caruaru, Brazil
[2] Fundacao Oswaldo Cruz, Ctr Pesquisa Aggeu Magalhaes, Dept Parasitol, Recife, PE, Brazil
[3] Univ Pernambuco, Inst Ciencias Biol, Recife, PE, Brazil
[4] Fundacao Hematol & Hemoterapia Pernambuco, Recife, PE, Brazil
[5] Univ Pernambuco, Fac Ciencias Med, Recife, PE, Brazil
来源
关键词
EPIDEMIOLOGY; COINFECTION; DIAGNOSIS; MORTALITY;
D O I
10.4269/ajtmh.17-0787
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Common in four continents, visceral leishmaniasis (VL) is an important but neglected disease. Human immunodeficiency virus (HIV) infection increases the risk of developing VL in people from leishmaniasis-endemic areas, with worse prognosis when there is coinfection. We conducted a cross-sectional study to determine the prevalence of HIV/VL coinfection in patients admitted in three referral hospitals for HIV/acquired immunodeficiency syndrome (AIDS) in Pernambuco, Brazil, and to compare epidemiological, clinical, and laboratory characteristics among HIV/VL coinfected and HIV mono-infected individuals. The sample consisted of HIV patients aged 18 years or more, in a period of data collection of 6 months. We performed four Leishmania tests-polymerase chain reaction (PCR), direct agglutination test, rK39, and latex agglutination test-and individuals with at least one positive test were considered coinfected. The HIV/VL coinfection prevalence we found was 16.9%. We observed large variation in prevalence according to the Leishmania test used, with low coincidence of positive tests. The most frequent symptoms found were weight loss (75.6%), fever (67.6%), and cough (55.3%). When we compared HIV/VL coinfected and HIV mono-infected groups we did not observe statistically significant differences. Low educational level (P = 0.004) and pallor (P = 0.009) were more frequent in the coinfected group. Serum albumin level was higher in coinfected individuals (P = 0.009). It is important to follow-up these individuals to understand the dynamics of VL in people living with HIV. New tests are necessary, ideally differentiating active from latent infection. Testing for VL in people with HIV is important and should be considered as part of the initial investigation in these individuals.
引用
收藏
页码:1541 / 1546
页数:6
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