Infection Prevention and Control

Purpose: In Iran, HIV/AIDS is an emerging disease and both Visceral Leishmaniasis (VL) and HIV infections occur sporadically. The known causative agent in Iran for VL is Leishmania infantum which is endemic in Ardabil and Fars Provinces. The aim of this study is to report of VL caused by Leishmania major in an AIDS patient.

 

Methods: Direct agglutination test (DAT) was performed on a 53 year old HIV/infected male with chronic intermittent diarrhea who registered in AIDS center of Khorasan Razavi Province to investigate VL/HIV co infection. The mean of CD4+ was 79/mm³ in this patient. The DAT result was confirmed by bone marrow aspiration and polymerase chain reaction (PCR).

 

Results: DAT test was positive with titer 1:25,600. The amastigote forms of Leishmania sp. were found in bone marrow aspiration materials and L. major was identified by nested PCR assay compared to standard pattern.

 

Conclusions: Based on the DAT and PCR results for VL, it is recommended that a high sensitive serological test should be performed on HIV positive patients, especially in where are endemic for VL. Other Leishmania sp. could be causative agents for VL in immunocompromised people; therefore the observed amastigotes in bone marrow aspiration should be examined by molecular methods to identify Leishmania sp. VL/HIV co-infection can occur in endemic areas for cutaneous leishmaniasis, so some studies are proposed to investigate VL caused by CL causative agents in HIV patients.