• Main Authors: Luciana Almeida Silva, Héctor Dardo Romero, Aline Fagundes, Nédia Nehme, Otávio Fernandes, Virmondes Rodrigues, Roberto Teodoro Costa, Aluízio Prata
• Format: Article
• Language: English
• Published: Universidade de São Paulo 2013-04-01
• Series: Revista do Instituto de Medicina Tropical de São Paulo
• Subjects: Visceral leishmaniasis; Asymptomatic; Diagnosis; Polymerase chain reaction
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0036-46652013000200101

<p id="para1">The diagnosis of asymptomatic infection with Leishmania (Leishmania) chagasi has become more important over recent years. Expansion of visceral leishmaniasis might be associated with other routes of transmission such as transfusion, congenital or even vector transmission, and subjects with asymptomatic infection are potential reservoirs. Moreover, the identification of infection may contribute to the management of patients with immunosuppressive conditions (HIV, transplants, use of immunomodulators) and to the assessment of the effectiveness of control measures. In this study, 149 subjects living in a visceral leishmaniasis endemic area were evaluated clinically and submitted to genus-specific polymerase chain reaction (PCR), serological testing, and the Montenegro skin test. Forty-nine (32.9%) of the subjects had a positive PCR result and none of them developed the disease within a follow-up period of three years. No association was observed between the results of PCR, serological and skin tests. A positive PCR result in subjects from the endemic area did not indicate a risk of progression to visceral leishmaniasis and was not associated with a positive result in the serological tests.<br><p id="para2">O diagn&#243;stico de infec&#231;&#227;o assintom&#225;tica por Leishmania (Leishmania) chagasi tem assumido crescente import&#226;ncia nos &#250;ltimos anos. A expans&#227;o da leishmaniose visceral pode estar associada a outras vias de transmiss&#227;o tais como transfusional, cong&#234;nita, ou mesmo vetorial, sendo os indiv&#237;duos com infec&#231;&#227;o assintom&#225;tica, potenciais reservat&#243;rios. Ademais, a identifica&#231;&#227;o da infec&#231;&#227;o poderia auxiliar na condu&#231;&#227;o dos pacientes com condi&#231;&#245;es de imunossupress&#227;o (HIV, transplante, uso de imunomoduladores) e na avalia&#231;&#227;o da efetividade das medidas de controle. Neste estudo, foram avaliados clinicamente 149 indiv&#237;duos residentes em &#225;rea end&#234;mica de leishmaniose visceral e realizada a rea&#231;&#227;o em cadeia da polimerase (PCR) g&#234;nero-espec&#237;fica, testes sorol&#243;gicos e teste de Montenegro. Destes, 49 (32,9%) apresentaram PCR positiva, dos quais nenhum evoluiu com cl&#237;nica de leishmaniose visceral nos tr&#234;s anos subsequentes. N&#227;o houve associa&#231;&#227;o entre o resultado da PCR, dos exames sorol&#243;gicos e do teste cut&#226;neo. A positividade da PCR em indiv&#237;duos da &#225;rea end&#234;mica estudada n&#227;o indicou risco de progress&#227;o para leishmaniose visceral e tamb&#233;m n&#227;o foi associada &#224; maior positividade dos testes sorol&#243;gicos.