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Longitudinal evaluation of asymptomatic Leishmania infection in HIV-infected individuals in North-West Ethiopia: a pilot study. / van Griensven, Johan; van Henten, Saskia; Mengesha, Bewketu; Kassa, Mekibib; Adem, Emebet; Endris Seid, Mengistu; Abdellati, Said; Asefa, Wondimu; Simegn, Tesfa; Debasu, Degnachew; Bogale, Tadfe; Gedamu, Yonas; Van den Bossche, Dorien; Adriaensen, Wim; Van der Auwera, Gert; Cnops, Lieselotte; Vogt, Florian; Diro, Ermias.

In: PLoS Neglected Tropical Diseases, Vol. 13, Nr. 10, 0007765, 2019, blz. e0007765.

Onderzoeksoutput: Bijdrage aan tijdschriftA1: Web of Science-artikel

Harvard

van Griensven, J, van Henten, S, Mengesha, B, Kassa, M, Adem, E, Endris Seid, M, Abdellati, S, Asefa, W, Simegn, T, Debasu, D, Bogale, T, Gedamu, Y, Van den Bossche, D, Adriaensen, W, Van der Auwera, G, Cnops, L, Vogt, F & Diro, E 2019, 'Longitudinal evaluation of asymptomatic Leishmania infection in HIV-infected individuals in North-West Ethiopia: a pilot study', PLoS Neglected Tropical Diseases, vol. 13, nr. 10, 0007765, blz. e0007765. https://doi.org/10.1371/journal.pntd.0007765

APA

van Griensven, J., van Henten, S., Mengesha, B., Kassa, M., Adem, E., Endris Seid, M., ... Diro, E. (2019). Longitudinal evaluation of asymptomatic Leishmania infection in HIV-infected individuals in North-West Ethiopia: a pilot study. PLoS Neglected Tropical Diseases, 13(10), e0007765. [0007765]. https://doi.org/10.1371/journal.pntd.0007765

Vancouver

Author

van Griensven, Johan ; van Henten, Saskia ; Mengesha, Bewketu ; Kassa, Mekibib ; Adem, Emebet ; Endris Seid, Mengistu ; Abdellati, Said ; Asefa, Wondimu ; Simegn, Tesfa ; Debasu, Degnachew ; Bogale, Tadfe ; Gedamu, Yonas ; Van den Bossche, Dorien ; Adriaensen, Wim ; Van der Auwera, Gert ; Cnops, Lieselotte ; Vogt, Florian ; Diro, Ermias. / Longitudinal evaluation of asymptomatic Leishmania infection in HIV-infected individuals in North-West Ethiopia: a pilot study. In: PLoS Neglected Tropical Diseases. 2019 ; Vol. 13, Nr. 10. blz. e0007765.

BibTeX

@article{8e6cfaa23a2a4869a230cabe5811ded5,
title = "Longitudinal evaluation of asymptomatic Leishmania infection in HIV-infected individuals in North-West Ethiopia: a pilot study",
abstract = "BACKGROUND: In endemic regions, asymptomatic Leishmania infection is common. In HIV patients, detection of asymptomatic Leishmania infection could potentially identify those at risk of visceral leishmaniasis (VL). However, data on the prevalence, incidence, and determinants of asymptomatic infection, and the risk of VL are lacking.METHODS: We conducted a cross-sectional survey at a single ART centre, followed by a prospective cohort study amongst HIV-infected adults in HIV care in a district hospital in a VL-endemic area in North-West Ethiopia (9/2015-8/2016). Asymptomatic Leishmania infection was detected using the direct agglutination test (DAT), rK39-rapid diagnostic test (RDT)), PCR on peripheral blood and the KAtex urine antigen test, and defined as positivity on any Leishmania marker. All individuals were followed longitudinally (irrespective of the Leishmania test results). Risk factors for asymptomatic Leishmania infection were determined using logistic regression.RESULTS: A total of 534 HIV-infected individuals enrolled in HIV care were included in the study. After excluding 13 patients with a history of VL and an 10 patients with incomplete baseline Leishmania tests, 511 were included in analysis. The median age was 38 years (interquartile range (IQR) 30-45), 62.6{\%} were male. The median follow-up time was 12 months (IQR 9-12). No deaths were reported during the study period. Most (95.5{\%}) were on antiretroviral treatment at enrolment, for a median of 52 months (IQR 27-79). The median CD4 count at enrolment was 377 cells/mm3 (IQR 250-518). The baseline prevalence of Leishmania infection was 12.8{\%} in males and 4.2{\%} in females. Overall, 7.4{\%} tested positive for rK39, 4.3{\%} for DAT, 0.2{\%} for PCR and 0.2{\%} for KAtex. Independent risk factors for a prevalent infection were male sex (odds ratio (OR) 3.2; 95{\%} confidence intervals (CI) 14-7.0) and concurrent malaria infection (OR 6.1; 95{\%} CI 1.9-18.9). Amongst the 49 prevalent (baseline) infections with further follow-up, the cumulative incidence of losing the Leishmania markers by one year was 40.1{\%}. There were 36 incident infections during the course of the study, with a cumulative one-year risk of 9.5{\%}. Only one case of VL was detected during follow-up.CONCLUSIONS: We found a high prevalence of asymptomatic Leishmania infection, persisting in most cases. The incidence was more modest and overt VL was rare. Larger and longer studies with more complete follow-up may help to decide whether a test and treat strategy would be justified in this context.TRIAL REGISTRATION: ClinicalTrials.gov NCT02839603.",
keywords = "VISCERAL LEISHMANIASIS, OPPORTUNISTIC INFECTIONS, PREVALENCE, INFANTUM",
author = "{van Griensven}, Johan and {van Henten}, Saskia and Bewketu Mengesha and Mekibib Kassa and Emebet Adem and {Endris Seid}, Mengistu and Said Abdellati and Wondimu Asefa and Tesfa Simegn and Degnachew Debasu and Tadfe Bogale and Yonas Gedamu and {Van den Bossche}, Dorien and Wim Adriaensen and {Van der Auwera}, Gert and Lieselotte Cnops and Florian Vogt and Ermias Diro",
note = "CPDF; CUNIT",
year = "2019",
doi = "10.1371/journal.pntd.0007765",
language = "English",
volume = "13",
pages = "e0007765",
journal = "PLoS Neglected Tropical Diseases",
issn = "1935-2727",
publisher = "Public Library of Science",
number = "10",

}

RIS

TY - JOUR

T1 - Longitudinal evaluation of asymptomatic Leishmania infection in HIV-infected individuals in North-West Ethiopia: a pilot study

AU - van Griensven, Johan

AU - van Henten, Saskia

AU - Mengesha, Bewketu

AU - Kassa, Mekibib

AU - Adem, Emebet

AU - Endris Seid, Mengistu

AU - Abdellati, Said

AU - Asefa, Wondimu

AU - Simegn, Tesfa

AU - Debasu, Degnachew

AU - Bogale, Tadfe

AU - Gedamu, Yonas

AU - Van den Bossche, Dorien

AU - Adriaensen, Wim

AU - Van der Auwera, Gert

AU - Cnops, Lieselotte

AU - Vogt, Florian

AU - Diro, Ermias

N1 - CPDF; CUNIT

PY - 2019

Y1 - 2019

N2 - BACKGROUND: In endemic regions, asymptomatic Leishmania infection is common. In HIV patients, detection of asymptomatic Leishmania infection could potentially identify those at risk of visceral leishmaniasis (VL). However, data on the prevalence, incidence, and determinants of asymptomatic infection, and the risk of VL are lacking.METHODS: We conducted a cross-sectional survey at a single ART centre, followed by a prospective cohort study amongst HIV-infected adults in HIV care in a district hospital in a VL-endemic area in North-West Ethiopia (9/2015-8/2016). Asymptomatic Leishmania infection was detected using the direct agglutination test (DAT), rK39-rapid diagnostic test (RDT)), PCR on peripheral blood and the KAtex urine antigen test, and defined as positivity on any Leishmania marker. All individuals were followed longitudinally (irrespective of the Leishmania test results). Risk factors for asymptomatic Leishmania infection were determined using logistic regression.RESULTS: A total of 534 HIV-infected individuals enrolled in HIV care were included in the study. After excluding 13 patients with a history of VL and an 10 patients with incomplete baseline Leishmania tests, 511 were included in analysis. The median age was 38 years (interquartile range (IQR) 30-45), 62.6% were male. The median follow-up time was 12 months (IQR 9-12). No deaths were reported during the study period. Most (95.5%) were on antiretroviral treatment at enrolment, for a median of 52 months (IQR 27-79). The median CD4 count at enrolment was 377 cells/mm3 (IQR 250-518). The baseline prevalence of Leishmania infection was 12.8% in males and 4.2% in females. Overall, 7.4% tested positive for rK39, 4.3% for DAT, 0.2% for PCR and 0.2% for KAtex. Independent risk factors for a prevalent infection were male sex (odds ratio (OR) 3.2; 95% confidence intervals (CI) 14-7.0) and concurrent malaria infection (OR 6.1; 95% CI 1.9-18.9). Amongst the 49 prevalent (baseline) infections with further follow-up, the cumulative incidence of losing the Leishmania markers by one year was 40.1%. There were 36 incident infections during the course of the study, with a cumulative one-year risk of 9.5%. Only one case of VL was detected during follow-up.CONCLUSIONS: We found a high prevalence of asymptomatic Leishmania infection, persisting in most cases. The incidence was more modest and overt VL was rare. Larger and longer studies with more complete follow-up may help to decide whether a test and treat strategy would be justified in this context.TRIAL REGISTRATION: ClinicalTrials.gov NCT02839603.

AB - BACKGROUND: In endemic regions, asymptomatic Leishmania infection is common. In HIV patients, detection of asymptomatic Leishmania infection could potentially identify those at risk of visceral leishmaniasis (VL). However, data on the prevalence, incidence, and determinants of asymptomatic infection, and the risk of VL are lacking.METHODS: We conducted a cross-sectional survey at a single ART centre, followed by a prospective cohort study amongst HIV-infected adults in HIV care in a district hospital in a VL-endemic area in North-West Ethiopia (9/2015-8/2016). Asymptomatic Leishmania infection was detected using the direct agglutination test (DAT), rK39-rapid diagnostic test (RDT)), PCR on peripheral blood and the KAtex urine antigen test, and defined as positivity on any Leishmania marker. All individuals were followed longitudinally (irrespective of the Leishmania test results). Risk factors for asymptomatic Leishmania infection were determined using logistic regression.RESULTS: A total of 534 HIV-infected individuals enrolled in HIV care were included in the study. After excluding 13 patients with a history of VL and an 10 patients with incomplete baseline Leishmania tests, 511 were included in analysis. The median age was 38 years (interquartile range (IQR) 30-45), 62.6% were male. The median follow-up time was 12 months (IQR 9-12). No deaths were reported during the study period. Most (95.5%) were on antiretroviral treatment at enrolment, for a median of 52 months (IQR 27-79). The median CD4 count at enrolment was 377 cells/mm3 (IQR 250-518). The baseline prevalence of Leishmania infection was 12.8% in males and 4.2% in females. Overall, 7.4% tested positive for rK39, 4.3% for DAT, 0.2% for PCR and 0.2% for KAtex. Independent risk factors for a prevalent infection were male sex (odds ratio (OR) 3.2; 95% confidence intervals (CI) 14-7.0) and concurrent malaria infection (OR 6.1; 95% CI 1.9-18.9). Amongst the 49 prevalent (baseline) infections with further follow-up, the cumulative incidence of losing the Leishmania markers by one year was 40.1%. There were 36 incident infections during the course of the study, with a cumulative one-year risk of 9.5%. Only one case of VL was detected during follow-up.CONCLUSIONS: We found a high prevalence of asymptomatic Leishmania infection, persisting in most cases. The incidence was more modest and overt VL was rare. Larger and longer studies with more complete follow-up may help to decide whether a test and treat strategy would be justified in this context.TRIAL REGISTRATION: ClinicalTrials.gov NCT02839603.

KW - VISCERAL LEISHMANIASIS

KW - OPPORTUNISTIC INFECTIONS

KW - PREVALENCE

KW - INFANTUM

U2 - 10.1371/journal.pntd.0007765

DO - 10.1371/journal.pntd.0007765

M3 - A1: Web of Science-article

C2 - 31593563

VL - 13

SP - e0007765

JO - PLoS Neglected Tropical Diseases

JF - PLoS Neglected Tropical Diseases

SN - 1935-2727

IS - 10

M1 - 0007765

ER -

ID: 3122406