Rapid Tests and the Diagnosis of Visceral Leishmaniasis and Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome Coinfection
Rapid Tests and the Diagnosis of Visceral Leishmaniasis and Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome Coinfection
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DOI：
10.4269/ajtmh.14-0798
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发表时间：
2015-11-01
影响因子：
3.3
通讯作者：
Medeiros, Zulma
中科院分区：
文献类型：
--
作者：
Barbosa Junior, Walter Lins;Ramos de Araujo, Paulo Sergio;Medeiros, Zulma
在人类免疫缺陷病毒(HIV)/获得性免疫缺陷综合征(AIDS)出现后，内脏利什曼病(VL)-艾滋病毒/艾滋病混合感染的人数在全球范围内有所增加。在此，我们评估了以rK39为基础的免疫层析检测(RK39 ICT)(DiaMed-IT LEISH(R)；DiaMed AG，瑞士克雷西耶-滨莫拉特)和乳胶凝集试验(Katex；Kalon Bioology，英国，吉尔福德)对来自巴西东北部的15名艾滋病毒/艾滋病患者进行尿抗原检测以诊断VL的有效性。VL的诊断基于临床表现、细胞学、血清学、寄生虫DNA和/或尿抗原检测。15例HIV/AIDS患者中有7例确诊为VL。仅3例患者骨髓细胞学检查阳性，3例常规聚合酶链式反应(PCR)阳性，6例实时荧光定量PCR阳性。所有患者的直接凝集试验(DAT)(荷兰阿姆斯特丹皇家热带研究所)均为阳性；其中4人经rK39 ICT检测呈阳性，5人经Katex检测呈阳性。需要进行大规模研究，以验证Katex在巴西国家公共卫生实验室网络中的使用情况，目的是改善该国艾滋病毒/艾滋病患者的VL诊断。
After the emergence of the human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), the number of visceral leishmaniasis (VL)-HIV/AIDS coinfections has increased worldwide. Herein, we assessed the usefulness of an rK39-based immunochromatographic test (rK39 ICT) (DiaMed-IT LEISH (R); DiaMed AG, Cressier-sur-Morat, Switzerland) and a latex agglutination test (KAtex; Kalon Biological, Guildford, United Kingdom) for urinary antigen detection to diagnose VL in 15 HIV/AIDS patients from northeastern Brazil. VL diagnosis was based on clinical findings, cytology, serology, parasite DNA, and/or urinary antigen detection. VL was confirmed in seven out of 15 HIV/AIDS patients. Only three patients were positive in bone marrow cytology, three patients were conventional polymerase chain reaction (PCR) positive, while six were real-time PCR positive. All patients were direct agglutination test (DAT) (Royal Tropical Institute, Amsterdam, The Netherlands) positive; of these, four were positive by rK39 ICT and five by KAtex. Large-scale studies are needed to validate the use of the KAtex in the national public health laboratory network in Brazil, aiming at improving the diagnosis of VL in HIV/AIDS patients in this country.