New record of preclinical diagnosis of American visceral leishmaniasis in Amazonian Brazil encourages optimizing disease control

Author(s)

Lima, Luciana ^[1] ; Vasconcelos-dos-Santos, Thiago ^[1] ; Campos, Marliane ^[1] ; Ramos, Patricia Karla ^[1] ; Gomes, Claudia ^[2] ; Laurenti, Marcia ^[2] ; da Matta, Vania ^[2] ; Corbett, Carlos ^[2] ; Silveira, Fernando ^{[1, 3]}

Affiliation

^[1] Evandro Chagas Inst, Parasitol Dept, Rod BR 316, KM 07, BR-67030000 Ananindeua, Para - Brazil

^[2] Univ Sao Paulo, Med Sch, Pathol Dept, Sao Paulo, SP - Brazil

^[3] Fed Univ Para, Nucleus Trop Med, Belem, Para - Brazil

• Document type: Journal article
• Source: PARASITE EPIDEMIOLOGY AND CONTROL; v. 10, AUG 2020.
• Web of Science Citations: 1

Abstract

The clinical-immunological spectrum of human Leishmania (L) infantum chagasi-infection in Amazonian Brazil has recently been reviewed based on the combined use of the delayed-type hypersensitivity (DTH) and indirect fluorescence antibody test (IFAT-IgG/IgM), both with homologous L (L) infantum chagasi-antigens, and associated with the clinical evaluation of infected individuals. This diagnostic approach has allowed to identify the broadest clinical-immunological spectrum of human L. (L.) infantum chagasi-infection composed by five clinical-immunological profiles of infection: three asymptomatic, 1) Asymptomatic Infection (Al) {[}DTH+/++++, IFAT(-)], 2) Subclinical Resistant Infection (SRI) {[}DTH+/++++, IFAT(+/++)], and 3) Indeterminate Initial Infection (III) {[}DTH-, IFAT(+/++)], and two symptomatic ones, 4) Symptomatic Infection (SI) {[}-American visceral leishmaniasis - AVLJ and, 5) Subclinical Oligosymplomatic Infection (SOI), both with the same immune profile {[}DTH-, IFAT(+++/++++)]. Herein, we confirm for the third time the preclinical diagnosis of AVL through IgMantibody response in an early asymptomatic case of infection (profile III), a 17-year-old boy who evolved to AVL (=profile SI) six weeks after the initial infection diagnosis, confirming that the combined use of DTH and IFAT-(IgG/IgM) assays associated with the clinical evaluation of infected individuals is potentially useful for monitoring human L. (L.) infantum chagasi-infection in endemic areas as well as optimizing AVL control. (C) 2020 Published by Elsevier Ltd on behalf of World Federation of Parasitologists. (AU)

• FAPESP's process: 14/50315-0 - Leishmaniasis in Latin America: an advanced perspective on immunopathogenetic factors of cutaneous and visceral infection, immunomodulators of the sandflies vector saliva and immunogenic exo-antigens of Leishmania (L.) infantum chagasi as vaccine candidates
• Grantee: Marcia Dalastra Laurenti
• Support Opportunities: Research Projects - Thematic Grants