Performance of two immunochromatographic tests for diagnosis of visceral leishmaniasis in patients coinfected with HIV

Because of visceral leishmaniasis (VL) urbanization and spreading of the human immunodeficiency virus (HIV) infection to rural areas, coinfection has become more common. Here, we compared the accuracy of Kalazar Detect® (KD), an rK39-based immunochromatographic (IC) test, and OrangeLife® (OL), an rK...

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Bibliographic Details
Published in:Parasitology research (1987) 2018-02, Vol.117 (2), p.419-427
Main Authors: da Silva, Mauro Roberto Biá, Brandão, Natália Alberto Alves, Colovati, Marco, de Sousa, Margella Marconcine Pinheiro, de Lima, Larissa Coelho, Dorta, Miriam Leandro, Ribeiro-Dias, Fátima, Costa, Dorcas Lamounier, Costa, Carlos Henrique Nery, de Oliveira, Milton Adriano Pelli
Format: Article
Language:English
Subjects:
Adult
Antigens, Protozoan - immunology
Biomedical and Life Sciences
Biomedicine
Bone marrow
Brazil
Chromatography
Coinfection
Comparative analysis
Diagnosis
Female
HIV
HIV Infections - complications
HIV patients
Human immunodeficiency virus
Humans
Immunoassay
Immunochromatography - methods
Immunoglobulin G
Immunology
Leishmaniasis, Visceral - complications
Leishmaniasis, Visceral - diagnosis
Male
Medical Microbiology
Microbiology
Original Paper
Parasitic diseases
Physiological aspects
Protozoan Proteins - immunology
Sensitivity and Specificity
Serological tests
Urbanization
Visceral leishmaniasis
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Summary:Because of visceral leishmaniasis (VL) urbanization and spreading of the human immunodeficiency virus (HIV) infection to rural areas, coinfection has become more common. Here, we compared the accuracy of Kalazar Detect® (KD), an rK39-based immunochromatographic (IC) test, and OrangeLife® (OL), an rK39 + rK28 IC test, for diagnosing VL in patients coinfected with HIV in an endemic area in Brazil. Seventy-six VL patients and 40 patients with other diseases, of which 31 and 21 patients, respectively, were infected with HIV, were examined. The sensitivity of OL and KD tests was 88.89 and 95.45%, respectively, in patients without HIV. The sensitivity dropped to 67.74 and 61.29%, respectively, in coinfected patients. The decrease in sensitivity was not related to a decrease in the production of Leishmania -specific IgG. Because of the low sensitivity of rk39 test in HIV-infected patients, we suggest that patients with negative rK39 results should undergo further investigation with additional serological tests that are not based only on the rK39 antigen and examination of bone marrow aspirates.
ISSN:0932-0113
1432-1955
DOI:10.1007/s00436-017-5716-3