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Development and evaluation of diagnostics for visceral leishmaniasis (VL) in HIV patients in elimination settings.

消除环境中 HIV 患者内脏利什曼病 (VL) 诊断的开发和评估。

基本信息

批准号：
1964911
负责人：
金额：
--
依托单位：
Liverpool School of Tropical Medicine
依托单位国家：
英国
项目类别：
Studentship
财政年份：
2017
资助国家：
英国
起止时间：
2017 至无数据
项目状态：
已结题

来源：
https://gtr.ukri.org/projects?ref=studentship-1964911
关键词：
Development evaluation diagnostics visceral leishmaniasis

项目摘要

Introduction: People living with HIV (PLHIV) have poor outcomes associated with visceral leishmaniasis (VL), including an increased risk of treatment failure and mortality. The prevalence of asymptomatic Leishmania infection in PLHIV in India remains unknown.Aim: In this study, led by Médecins Sans Frontières, we aim to determine the prevalence and determinants of asymptomatic Leishmania infection in PLHIV in Bihar, India. We then evaluate methods for detecting asymptomatic Leishmania infection in this cohort.Methods: A total of 1,296 PLHIV, with no history or symptoms of VL or post kala-azar dermal leishmaniasis, were recruited at anti-retroviral therapy clinics in endemic districts of Bihar between May 2018 and May 2019. Quantitative polymerase chain reaction (qPCR), rK39 enzyme-linked immunosorbent assay (ELISA) and rK39 rapid diagnostic tests (RDT) were carried out on peripheral blood. The Leishmania antigen ELISA was carried out on urine.Results: The prevalence of asymptomatic Leishmania infection was 7.4% (n=96) as detected by qPCR (0.5%, n=6), rK39 ELISA (7.4%, n=96), and rK39 RDT (0.4%, n=5). An additional 20 (1.5%) participants had Leishmania antigenuria as detected by the Leishmania antigen ELISA, 28 (2.2%) in total. CD4 counts of <100 and 100-199 were found to be determinants of asymptomatic Leishmania infection with odds ratios of 3.1 (95% confidence intervals (CI) 1.2-7.6) and 2.1 (95% CI: 1.1-4.0), respectively.Conclusion: Asymptomatic Leishmania infection was found to persist in a cohort of PLHIV in India, with patients with low CD4 counts at an increased risk.

介绍：艾滋病毒感染者（PLHIV）与内脏利什曼病（VL）相关的结果很差，包括治疗失败和死亡的风险增加。无症状利什曼原虫感染PLHIVinIndia.Aim的患病率：在这项研究中，由无国界医生组织领导，我们的目的是确定在印度比哈尔邦的PLHIV无症状利什曼原虫感染的患病率和决定因素。然后，我们评估方法检测无症状利什曼原虫infection in this coherent.Methods：共1,296 PLHIV，没有VL或黑热病后皮肤利什曼病的历史或症状，被招募在抗逆转录病毒治疗诊所流行区的比哈尔邦2018年5月至2019年5月。对外周血进行定量聚合酶链反应（qPCR）、rK 39酶联免疫吸附试验（ELISA）和rK 39快速诊断试验（RDT）。结果：qPCR法（0.5%，n=6）、rK 39 ELISA法（7.4%，n = 96）和rK 39 RDT法（0.4%，n=5）检测到96例无症状利什曼原虫感染，阳性率为7.4%。另外20名（1.5%）参与者通过利什曼原虫抗原ELISA检测到利什曼原虫抗原尿，共28名（2.2%）。CD 4计数<100和100-199被发现是无症状利什曼原虫感染的决定因素，优势比为3.1（95%置信区间（CI）1.2-7.6）和2.1（95% CI：1.1-4.0）。在印度的一个PLHIV队列中发现无症状的利什曼原虫感染持续存在，CD 4计数低的患者风险增加。