Serological and molecular tools to diagnose visceral leishmaniasis: 2-years’ experience of a single center in Northern Italy

Stefania Varani, Margherita Ortalli, Luciano Attard, Elisa Vanino, Paolo Gaibani, Caterina Vocale, Giada Rossini, Roberto Cagarelli, Anna Pierro, Patrizia Billi, Antonio Mastroianni, Simona Di Cesare, Mauro Codeluppi, Erica Franceschini, Fraia Melchionda, Marina Gramiccia, Aldo Scalone, Giovanna A. Gentilomi, Maria P. Landini

Research output: Contribution to journalArticle

Abstract

The diagnosis of visceral leishmaniasis (VL) remains challenging, due to the limited sensitivity of microscopy, the poor performance of serological methods in immunocompromised patients and the lack of standardization of molecular tests. The aim of this study was to implement a combined diagnostic workflow by integrating serological and molecular tests with standardized clinical criteria. Between July 2013 and June 2015, the proposed workflow was applied to specimens obtained from 94 in-patients with clinical suspicion of VL in the Emilia-Romagna region, Northern Italy. Serological tests and molecular techniques were employed. Twenty-one adult patients (22%) had a confirmed diagnosis of VL by clinical criteria, serology and/or real-time polymerase chain reaction; 4 of these patients were HIV-positive. Molecular tests exhibited higher sensitivity than serological tests for the diagnosis of VL. In our experience, the rK39 immunochromatographic test was insufficiently sensitive for use as a screening test for the diagnosis of VL caused by L. infantum in Italy. However, as molecular tests are yet not standardized, further studies are required to identify an optimal screening test for Mediterranean VL.

Original languageEnglish
Article numbere0183699
JournalPLoS One
Volume12
Issue number8
DOIs
Publication statusPublished - Aug 1 2017

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

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    Varani, S., Ortalli, M., Attard, L., Vanino, E., Gaibani, P., Vocale, C., Rossini, G., Cagarelli, R., Pierro, A., Billi, P., Mastroianni, A., Di Cesare, S., Codeluppi, M., Franceschini, E., Melchionda, F., Gramiccia, M., Scalone, A., Gentilomi, G. A., & Landini, M. P. (2017). Serological and molecular tools to diagnose visceral leishmaniasis: 2-years’ experience of a single center in Northern Italy. PLoS One, 12(8), [e0183699]. https://doi.org/10.1371/journal.pone.0183699