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 language | English |
|---|---|
| Article number | e0183699 |
| Journal | PLoS One |
| Volume | 12 |
| Issue number | 8 |
| DOIs | |
| Publication status | Published - Aug 1 2017 |
Fingerprint
ASJC Scopus subject areas
- Biochemistry, Genetics and Molecular Biology(all)
- Agricultural and Biological Sciences(all)
Cite this
Serological and molecular tools to diagnose visceral leishmaniasis : 2-years’ experience of a single center in Northern Italy. / Varani, Stefania; Ortalli, Margherita; Attard, Luciano; Vanino, Elisa; Gaibani, Paolo; Vocale, Caterina; Rossini, Giada; Cagarelli, Roberto; Pierro, Anna; Billi, Patrizia; Mastroianni, Antonio; Di Cesare, Simona; Codeluppi, Mauro; Franceschini, Erica; Melchionda, Fraia; Gramiccia, Marina; Scalone, Aldo; Gentilomi, Giovanna A.; Landini, Maria P.
In: PLoS One, Vol. 12, No. 8, e0183699, 01.08.2017.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Serological and molecular tools to diagnose visceral leishmaniasis
T2 - 2-years’ experience of a single center in Northern Italy
AU - Varani, Stefania
AU - Ortalli, Margherita
AU - Attard, Luciano
AU - Vanino, Elisa
AU - Gaibani, Paolo
AU - Vocale, Caterina
AU - Rossini, Giada
AU - Cagarelli, Roberto
AU - Pierro, Anna
AU - Billi, Patrizia
AU - Mastroianni, Antonio
AU - Di Cesare, Simona
AU - Codeluppi, Mauro
AU - Franceschini, Erica
AU - Melchionda, Fraia
AU - Gramiccia, Marina
AU - Scalone, Aldo
AU - Gentilomi, Giovanna A.
AU - Landini, Maria P.
PY - 2017/8/1
Y1 - 2017/8/1
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85028468459&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85028468459&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0183699
DO - 10.1371/journal.pone.0183699
M3 - Article
C2 - 28832646
AN - SCOPUS:85028468459
VL - 12
JO - PLoS One
JF - PLoS One
SN - 1932-6203
IS - 8
M1 - e0183699
ER -