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Clinical and parasitological factors in parasite persistence after treatment and clinical cure of cutaneous leishmaniasis

BACKGROUND: The determinants of parasite persistence or elimination after treatment and clinical resolution of cutaneous leishmaniasis (CL) are unknown. We investigated clinical and parasitological parameters associated with the presence and viability of Leishmania after treatment and resolution of...

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Autores principales: Martínez-Valencia, Alvaro J., Daza-Rivera, Carlos Frisherald, Rosales-Chilama, Mariana, Cossio, Alexandra, Casadiego Rincón, Elkin J., Desai, Mayur M., Saravia, Nancy Gore, Gómez, María Adelaida
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5526576/
https://www.ncbi.nlm.nih.gov/pubmed/28704369
http://dx.doi.org/10.1371/journal.pntd.0005713
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author Martínez-Valencia, Alvaro J.
Daza-Rivera, Carlos Frisherald
Rosales-Chilama, Mariana
Cossio, Alexandra
Casadiego Rincón, Elkin J.
Desai, Mayur M.
Saravia, Nancy Gore
Gómez, María Adelaida
author_facet Martínez-Valencia, Alvaro J.
Daza-Rivera, Carlos Frisherald
Rosales-Chilama, Mariana
Cossio, Alexandra
Casadiego Rincón, Elkin J.
Desai, Mayur M.
Saravia, Nancy Gore
Gómez, María Adelaida
author_sort Martínez-Valencia, Alvaro J.
collection PubMed
description BACKGROUND: The determinants of parasite persistence or elimination after treatment and clinical resolution of cutaneous leishmaniasis (CL) are unknown. We investigated clinical and parasitological parameters associated with the presence and viability of Leishmania after treatment and resolution of CL caused by L. Viannia. METHODS: Seventy patients who were treated with meglumine antimoniate (n = 38) or miltefosine (n = 32) and cured, were included in this study. Leishmania persistence and viability were determined by detection of kDNA and 7SLRNA transcripts, respectively, before, at the end of treatment (EoT), and 13 weeks after initiation of treatment in lesions and swabs of nasal and tonsillar mucosa. RESULTS: Sixty percent of patients (42/70) had evidence of Leishmania persistence at EoT and 30% (9/30) 13 weeks after treatment initiation. A previous episode of CL was found to be a protective factor for detectable Leishmania persistence (OR: 0.16, 95%CI: 0.03–0.92). kDNA genotyping could not discern differences between parasite populations that persisted and those isolated at diagnosis. CONCLUSIONS: Leishmania persist in skin and mucosal tissues in a high proportion of patients who achieved therapeutic cure of CL. This finding prompts assessment of the contribution of persistent infection in transmission and endemicity of CL, and in disease reactivation and protective immunity.
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spelling pubmed-55265762017-08-07 Clinical and parasitological factors in parasite persistence after treatment and clinical cure of cutaneous leishmaniasis Martínez-Valencia, Alvaro J. Daza-Rivera, Carlos Frisherald Rosales-Chilama, Mariana Cossio, Alexandra Casadiego Rincón, Elkin J. Desai, Mayur M. Saravia, Nancy Gore Gómez, María Adelaida PLoS Negl Trop Dis Research Article BACKGROUND: The determinants of parasite persistence or elimination after treatment and clinical resolution of cutaneous leishmaniasis (CL) are unknown. We investigated clinical and parasitological parameters associated with the presence and viability of Leishmania after treatment and resolution of CL caused by L. Viannia. METHODS: Seventy patients who were treated with meglumine antimoniate (n = 38) or miltefosine (n = 32) and cured, were included in this study. Leishmania persistence and viability were determined by detection of kDNA and 7SLRNA transcripts, respectively, before, at the end of treatment (EoT), and 13 weeks after initiation of treatment in lesions and swabs of nasal and tonsillar mucosa. RESULTS: Sixty percent of patients (42/70) had evidence of Leishmania persistence at EoT and 30% (9/30) 13 weeks after treatment initiation. A previous episode of CL was found to be a protective factor for detectable Leishmania persistence (OR: 0.16, 95%CI: 0.03–0.92). kDNA genotyping could not discern differences between parasite populations that persisted and those isolated at diagnosis. CONCLUSIONS: Leishmania persist in skin and mucosal tissues in a high proportion of patients who achieved therapeutic cure of CL. This finding prompts assessment of the contribution of persistent infection in transmission and endemicity of CL, and in disease reactivation and protective immunity. Public Library of Science 2017-07-13 /pmc/articles/PMC5526576/ /pubmed/28704369 http://dx.doi.org/10.1371/journal.pntd.0005713 Text en © 2017 Martínez-Valencia et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Martínez-Valencia, Alvaro J.
Daza-Rivera, Carlos Frisherald
Rosales-Chilama, Mariana
Cossio, Alexandra
Casadiego Rincón, Elkin J.
Desai, Mayur M.
Saravia, Nancy Gore
Gómez, María Adelaida
Clinical and parasitological factors in parasite persistence after treatment and clinical cure of cutaneous leishmaniasis
title Clinical and parasitological factors in parasite persistence after treatment and clinical cure of cutaneous leishmaniasis
title_full Clinical and parasitological factors in parasite persistence after treatment and clinical cure of cutaneous leishmaniasis
title_fullStr Clinical and parasitological factors in parasite persistence after treatment and clinical cure of cutaneous leishmaniasis
title_full_unstemmed Clinical and parasitological factors in parasite persistence after treatment and clinical cure of cutaneous leishmaniasis
title_short Clinical and parasitological factors in parasite persistence after treatment and clinical cure of cutaneous leishmaniasis
title_sort clinical and parasitological factors in parasite persistence after treatment and clinical cure of cutaneous leishmaniasis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5526576/
https://www.ncbi.nlm.nih.gov/pubmed/28704369
http://dx.doi.org/10.1371/journal.pntd.0005713
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