HIV/AIDS-associated visceral leishmaniasis in patients from an endemic area in Central-west Brazil

An increase in morbidity associated with visceral leishmaniasis (VL) in human immunodeficiency virus (HIV)/AIDS patients has been described in Africa and the Mediterranean. Despite the high endemicity of VL and HIV-1/AIDS in Brazil, this association has not been thoroughly investigated. Our aim was to evaluate the epidemiologic and clinical characteristics of VL-HIV-1/AIDS cases from Central-west [Mato Grosso do Sul (MS)] Brazil. Medical records of 23 VL-HIV-1/AIDS patients were reviewed. Patients were predominantly adult males (87%) and 34.8% of the patients were intravenous drug users (IVDU). Leishmaniasis was the first opportunistic infection in 60% of the HIV-1 patients. Fever occurred in all patients, although splenomegaly and hepatomegaly were absent in 21.7% of the cases. CD4+ T-cell counts were below 200 cells/mm³ in 80% of the cases and the counts did not increase after clinical remission despite antiretroviral therapy. The first drug chosen to treat the cases was antimonial, but the therapeutic regimen was altered to amphotericin B in 12 of 17 cases due to side effects. Relapses were reported in 56.5% of the patients. IVDU may constitute an important risk factor for the transmission of both diseases in MS. VL-HIV-1/AIDS patients in MS share similar clinical characteristics as those from other endemic regions worldwide. Thus, these findings are critical for improving the surveillance of VL-HIV/AIDS patients

DNA identification of Leishmania (Viannia) braziliensis in human saliva from a patient with American cutaneous leishmaniasis

This study aims to report the amplification of the DNA of Leishmania (V.) braziliensis, using polymerase chain reaction, obtained from the saliva of a patient with American cutaneous leishmaniasis who did not present any lesion in the oral mucosa. Amplification produced fragments of 103 bp, an estimated size employing Leishmania (V.) braziliensis primers (b1 e b2). The present results revealed, for the first time, that the in vitro amplification of Leishmania DNA using samples from the salivary fluid of a patient with American cutaneous leishmaniasis is possible. However, more studies are required with a larger number of participants to evaluate the usefulness of saliva as a non-invasive sample for PCR. The development of such non-invasive technique is necessary for the diagnosis of many diseases in the future, especially infectious and parasitic ones