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Asymptomatic carriers of Leishmania infantum in patients infected with human immunodeficiency virus (HIV) in Morocco

Parasitology Research volume 117, pages 1237–1244 (2018)Cite this article

Abstract

In Morocco, visceral leishmaniasis (VL) is a parasitic disease caused by the flagellated protozoan parasite Leishmania infantum. L. infantum is transmitted by the bite of female phlebotomine sandflies, and its main reservoir hosts are domestic dogs. Asymptomatic infection with L. infantum is more frequent than clinically apparent disease. In HIV-infected patients, the risk of clinical VL is increased due to immunosuppression that may reactivate latent infections. However, coinfected subjects do not necessarily develop VL and may remain as asymptomatic carriers depending on their immune status. The present study investigates the asymptomatic carriers of L. infantum in HIV-infected patients in central Morocco, where human cases of visceral leishmaniasis by L. infantum have been reported. A total of 200 HIV-infected patients attending the Infectious Diseases Unit of the Ibn Zohar Hospital of Marrakech participated in the study. Parasitological and serological blood analyses included a direct microscopic examination (DME), culture in Novy-McNeal-Nicolle (NNN) medium, and serology by indirect immunofluorescence (IFI). We found prevalence rates of 5% (10/200) by IFI, 3% (6/200) by DME, and 2.5% (5/200) by culture. The parasite was identified as L. infantum by PCR from positive cultures.

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Acknowledgements

The authors are very grateful to Dr. Kamhawi Shaden for the critical review of the paper and kind assistance.

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Affiliations

  1. Laboratory of Medical Analysis, Ibn Zohr Regional Hospital Center, Marrakech, Morocco

    M. Echchakery & K. Souhail

  2. Ecology and the Environment Laboratory L2E (URAC 32, CNRST ERACNERS 06), Faculty of Sciences Semlalia, Cadi Ayyad University, Marrakech, Morocco

    M. Echchakery, S. Boussaa & A. Boumezzough

  3. WHO Collaborating Centre for Leishmaniasis, Parasitology Service, National Center of Microbiology Institute of Health Carlos III, Ctra Pozuelo-Majadahonda, km 2, Majadahonda, 28220, Madrid, Spain

    J. Nieto, S. Ortega, C. Chicharro, E. Carrillo & J. Moreno

  4. ISPITS-Higher Institute of Nursing and Health Technology, Marrakech, Morocco

    S. Boussaa

  5. Department of Infectious Diseases, Ibn Zohr Regional Hospital Center, Marrakech, Morocco

    N. El Fajali & H. Aajly

Authors
  1. M. Echchakery
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  2. J. Nieto
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  3. S. Boussaa
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  4. N. El Fajali
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  5. S. Ortega
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  6. K. Souhail
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  7. H. Aajly
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  8. C. Chicharro
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  9. E. Carrillo
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  10. J. Moreno
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  11. A. Boumezzough
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Corresponding author

Correspondence to S. Boussaa.

Ethics declarations

This study was approved by the Hospital-University Ethics Committee under protocol number 020/2016. Authorization to examine files, interview, and take blood samples from HIV-infected patients was obtained from the Regional Health Directorate. A consent form was explained to and signed by all the participants.

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The authors declare that they have no competing interests.

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Echchakery, M., Nieto, J., Boussaa, S. et al. Asymptomatic carriers of Leishmania infantum in patients infected with human immunodeficiency virus (HIV) in Morocco. Parasitol Res 117, 1237–1244 (2018). https://doi.org/10.1007/s00436-018-5805-y

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  • DOI: https://doi.org/10.1007/s00436-018-5805-y

Keywords

  • Leishmania infantum
  • HIV
  • IFI
  • PCR
  • Coinfection
  • Morocco