VISCERAL LEISHMANIASIS -HIV COINFECTED PATIENTS ARE HIGHLY INFECTIOUS TO SAND FLIES IN ENDEMIC AREA OF BIHAR, INDIA

Intro: Visceral leishmaniasis (VL) is a fatal form of leishmaniasis caused by protozoan parasite Leishmania donovani and transmitted by the bites of blood sucking vector sand fly Phlebotomous argentipes. The spread and severity of infection is exacerbated by its status as an important co-infection o...

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Main Authors: O.P. Singh, R. Chaubey, A.K. Kushwaha, M. Fay, D. Sacks, S. Sundar
Format: Article
Language:English
Published: Elsevier 2023-05-01
Series:International Journal of Infectious Diseases
Online Access:http://www.sciencedirect.com/science/article/pii/S1201971223001832
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author O.P. Singh
R. Chaubey
A.K. Kushwaha
M. Fay
D. Sacks
S. Sundar
author_facet O.P. Singh
R. Chaubey
A.K. Kushwaha
M. Fay
D. Sacks
S. Sundar
author_sort O.P. Singh
collection DOAJ
description Intro: Visceral leishmaniasis (VL) is a fatal form of leishmaniasis caused by protozoan parasite Leishmania donovani and transmitted by the bites of blood sucking vector sand fly Phlebotomous argentipes. The spread and severity of infection is exacerbated by its status as an important co-infection of AIDS patients and the overlap in prevalence of HIV and leishmania species. We therefore performed xenodiagnosis to evaluate infectiousness of VL-HIV patients to sand flies in an area endemic for VL. Methods: In this prospective study, we performed direct xenodiagnosis using colonized female P. argentipes sand flies on 14 VL-HIV co-infected patients. During xenodiagnosis, 30 - 35 female flies were exposed for 30 min on each site on the subject's forearm and lower leg. Blood-engorged female flies were held in an environmental cabinet at 28°C and 85% humidity. At 60 -72 hours post- blood meal, flies were dissected and evaluated for L.donovani infection by microscopy as well as by quantitative polymerase chain reaction (qPCR). Findings: A total 732 sand flies were exposed on 14 VL-HIV patients having blood parasitemia roughly 42205 genomes / ml blood. We found that 16.66 % (122/732) of blood fed flies were found positive by microscopy. 92.8% (13 out of 14) HIV-VL patients transmitted infection to flies as reveled by qPCR and or microscopy. We modelled the proportion of flies that get infected based on blood parasitaemia, dividing the VL-HIV patients into three groups defined by qPCR values. We found that the probability of infection in any given blood fed fly correlated with severity of the disease (as defined by blood parasitemia), ranging from 4.92 % (95%CI 1.31 -16.39) in group 1 patients qPCR (0, 1e+04). to 15.39% (95% CI 4.11 – 43.55) in group 3 patients (qPCR 1e+05, 1e+06). Conclusion: Our findings confirm that VL-HIV patients are highly infectious to the vector.
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spelling doaj.art-3d9cb449c4804c159519b7953edd61df2023-05-18T04:38:04ZengElsevierInternational Journal of Infectious Diseases1201-97122023-05-01130S23VISCERAL LEISHMANIASIS -HIV COINFECTED PATIENTS ARE HIGHLY INFECTIOUS TO SAND FLIES IN ENDEMIC AREA OF BIHAR, INDIAO.P. Singh0R. Chaubey1A.K. Kushwaha2M. Fay3D. Sacks4S. Sundar5Banaras Hindu University, Department of Biochemistry, Varanasi, IndiaKala-azar Medical Research Centre, Entomology, Muzaffarpur, IndiaBanaras Hindu University, Medicine, Varanasi, IndiaNational Institute of allergy and Infectious Diseases, National Institute of Health, Biostatistics Research Branch, Bethesda, United States of AmericaNational Institute of allergy and Infectious Diseases, National Institute of Health, Laboratory of Parasitic Diseases, Bethesda, United States of AmericaBanaras Hindu University, Department of Medicine, Varanasi, IndiaIntro: Visceral leishmaniasis (VL) is a fatal form of leishmaniasis caused by protozoan parasite Leishmania donovani and transmitted by the bites of blood sucking vector sand fly Phlebotomous argentipes. The spread and severity of infection is exacerbated by its status as an important co-infection of AIDS patients and the overlap in prevalence of HIV and leishmania species. We therefore performed xenodiagnosis to evaluate infectiousness of VL-HIV patients to sand flies in an area endemic for VL. Methods: In this prospective study, we performed direct xenodiagnosis using colonized female P. argentipes sand flies on 14 VL-HIV co-infected patients. During xenodiagnosis, 30 - 35 female flies were exposed for 30 min on each site on the subject's forearm and lower leg. Blood-engorged female flies were held in an environmental cabinet at 28°C and 85% humidity. At 60 -72 hours post- blood meal, flies were dissected and evaluated for L.donovani infection by microscopy as well as by quantitative polymerase chain reaction (qPCR). Findings: A total 732 sand flies were exposed on 14 VL-HIV patients having blood parasitemia roughly 42205 genomes / ml blood. We found that 16.66 % (122/732) of blood fed flies were found positive by microscopy. 92.8% (13 out of 14) HIV-VL patients transmitted infection to flies as reveled by qPCR and or microscopy. We modelled the proportion of flies that get infected based on blood parasitaemia, dividing the VL-HIV patients into three groups defined by qPCR values. We found that the probability of infection in any given blood fed fly correlated with severity of the disease (as defined by blood parasitemia), ranging from 4.92 % (95%CI 1.31 -16.39) in group 1 patients qPCR (0, 1e+04). to 15.39% (95% CI 4.11 – 43.55) in group 3 patients (qPCR 1e+05, 1e+06). Conclusion: Our findings confirm that VL-HIV patients are highly infectious to the vector.http://www.sciencedirect.com/science/article/pii/S1201971223001832
spellingShingle O.P. Singh
R. Chaubey
A.K. Kushwaha
M. Fay
D. Sacks
S. Sundar
VISCERAL LEISHMANIASIS -HIV COINFECTED PATIENTS ARE HIGHLY INFECTIOUS TO SAND FLIES IN ENDEMIC AREA OF BIHAR, INDIA
International Journal of Infectious Diseases
title VISCERAL LEISHMANIASIS -HIV COINFECTED PATIENTS ARE HIGHLY INFECTIOUS TO SAND FLIES IN ENDEMIC AREA OF BIHAR, INDIA
title_full VISCERAL LEISHMANIASIS -HIV COINFECTED PATIENTS ARE HIGHLY INFECTIOUS TO SAND FLIES IN ENDEMIC AREA OF BIHAR, INDIA
title_fullStr VISCERAL LEISHMANIASIS -HIV COINFECTED PATIENTS ARE HIGHLY INFECTIOUS TO SAND FLIES IN ENDEMIC AREA OF BIHAR, INDIA
title_full_unstemmed VISCERAL LEISHMANIASIS -HIV COINFECTED PATIENTS ARE HIGHLY INFECTIOUS TO SAND FLIES IN ENDEMIC AREA OF BIHAR, INDIA
title_short VISCERAL LEISHMANIASIS -HIV COINFECTED PATIENTS ARE HIGHLY INFECTIOUS TO SAND FLIES IN ENDEMIC AREA OF BIHAR, INDIA
title_sort visceral leishmaniasis hiv coinfected patients are highly infectious to sand flies in endemic area of bihar india
url http://www.sciencedirect.com/science/article/pii/S1201971223001832
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