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High frequency of subclinical Leishmania infection among HIV-infected patients living in the endemic areas of visceral leishmaniasis in Fars province, southern Iran


Visceral leishmaniasis (VL) is a major health concern in patients with HIV infection in endemic areas of VL. In these areas, a substantial number of infected individuals are asymptomatic and the risk of acute VL infection in HIV/VL co-infected cases is high. The current study aimed to determine the prevalence of asymptomatic VL infection among HIV-infected patients in Fars province, southern Iran. Subjects of the study were 251 HIV-confirmed patients who all were clinically asymptomatic for leishmaniasis. Blood samples were obtained from each participant. Anti-Leishmania antibodies were detected in the sera using ELISA. DNA was extracted from the buffy coat of each subject and PCR amplified, targeting an ITS-2 gene of Leishmania. PCR products were purified from the gel and were sequenced. Overall, 19 out of 251 (7.6%) HIV-infected patients were found to be infected with Leishmania, using serological or molecular methods. Anti-Leishmania antibodies were detected in 13 (5.2%) patients and leishmanial DNA in 8 (3.2%) of the patients. The sequence analysis of DNA-positive cases revealed the species of the parasite as L. infantum. The high prevalence of VL among the patients with HIV is a serious challenge which demands further attention to improve the prophylaxis and treatment measurements of VL/HIV co-infection and thereby promoting the life expectancy and quality of life of these patients.

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The study was financially supported by the office of vice-chancellor for research of Shiraz University of Medical Sciences (Grant No. 9278). The study was the subject of Mrs. Mona Dehghani MD thesis.

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Correspondence to B. Sarkari.

Ethics declarations

The study was approved by and carried out under the guidelines of the Ethical Committee of the Shiraz University of medical sciences. All the study subjects provided their written informed consent for the collection of samples and subsequent analysis. Informed consent was obtained from each participant.

Conflict of interest

The authors declare that they have no competing interests.

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Rezaei, Z., Sarkari, B., Dehghani, M. et al. High frequency of subclinical Leishmania infection among HIV-infected patients living in the endemic areas of visceral leishmaniasis in Fars province, southern Iran. Parasitol Res 117, 2591–2595 (2018).

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  • Leishmania infantum
  • HIV
  • Co-infection
  • Subclinical
  • Visceral leishmaniasis
  • Iran