1. Comparison of parasitological, serological, and molecular tests for visceral leishmaniasis in HIV-infected patients: a cross-sectional delayed-type study.
- Author
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Cota GF, de Sousa MR, de Freitas Nogueira BM, Gomes LI, Oliveira E, Assis TS, de Mendonça AL, Pinto BF, Saliba JW, and Rabello A
- Subjects
- Adult, Antibodies, Protozoan blood, Coinfection diagnosis, Coinfection parasitology, Coinfection virology, Cross-Sectional Studies, DNA, Protozoan isolation & purification, Female, HIV Infections parasitology, Humans, Leishmania isolation & purification, Male, Middle Aged, Sensitivity and Specificity, Agglutination Tests methods, Fluorescent Antibody Technique, Indirect methods, Leishmaniasis, Visceral diagnosis, Real-Time Polymerase Chain Reaction methods
- Abstract
The aim of this study was to evaluate the accuracy of invasive and non-invasive tests for diagnosis of visceral leishmaniasis (VL) in a large series of human immunodeficiency virus (HIV)-infected patients. In this delayed-type cross-sectional study, 113 HIV-infected symptomatic patients were evaluated by an adjudication committee after clinical follow-up to establish the presence or absence of VL as the target condition (reference test). The index tests were recombinant K39 antigen-based immunochromatographic test (rK39), indirect fluorescent antibody test (IFAT), prototype kit of direct agglutination test (DAT-LPC), and real-time polymerase chain reaction (qPCR) in peripheral blood. Compared with parasitological test and adjudication committee diagnosis or latent class model analyses, IFAT and rk39 dipstick test presented the lowest sensitivity. DAT-LPC exhibited good overall performance, and there was no statistical difference between DAT-LPC and qPCR diagnosis accuracy. Real-time PCR emerges as a less invasive alternative to parasitological examination for confirmation of cases not identified by DAT.
- Published
- 2013
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