Universidad Peruana Cayetano Heredia

Quantitative Kinetoplast DNA Assessment During Treatment of Mucosal Leishmaniasis as a Potential Biomarker of Outcome: A Pilot Study

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dc.contributor.author Jara, Marlene
dc.contributor.author Valencia, B. M.
dc.contributor.author Adaui, Vanessa
dc.contributor.author Alba, Milena
dc.contributor.author Lau, Rachel
dc.contributor.author Arévalo Zelada, Jorge Luis
dc.contributor.author Llanos Cuentas, Elmer Alejandro
dc.contributor.author Boggild, Andrea K.
dc.date.accessioned 2019-02-06T14:57:38Z
dc.date.available 2019-02-06T14:57:38Z
dc.date.issued 2016
dc.identifier.uri https://hdl.handle.net/20.500.12866/5465
dc.description.abstract Mucosal leishmaniasis (ML) is a disfiguring manifestation of Leishmania (Viannia) infection. We evaluated parasite load (PL) over time as a potential biomarker of treatment outcome in ML. PL was assessed with kinetoplast DNA quantitative real-time polymerase chain reaction (kDNA-qPCR) at enrollment, days 14 and 21-28 of therapy and 3, 6, 12-18, and 18-24 months after treatment of ML and correlated to demographic, clinical, and parasitologic factors. Forty-four patients were enrolled: 30 men and 14 women. Enrollment PL differed significantly by causative species (P < 0.001), and was higher in patients with severe ML (nasal and laryngeal involvement) compared with those with only isolated nasal involvement (median = 1,285 versus 51.5 parasites/mug tissue DNA; P = 0.005). Two patterns of PL emerged: pattern 1 (N = 23) was characterized by a sequential decline in PL during and after therapy until kDNA was undetectable. Pattern 2 (N = 18) was characterized by clearance of detectable kDNA during treatment, followed by an increased PL thereafter. All patients who failed treatment (N = 4) demonstrated pattern 1. Leishmania (Viannia) braziliensis was overrepresented among those with pattern 2 (P = 0.019). PL can be quantified by cytology brush qPCR during and after treatment in ML. We demonstrate that treatment failure was associated with undetectable PL, and L. (V.) braziliensis infection was overrepresented in those with rebounding PL. en_US
dc.language.iso eng
dc.publisher American Society of Tropical Medicine and Hygiene
dc.relation.ispartofseries American Journal of Tropical Medicine and Hygiene (ASTMH Journal)
dc.rights info:eu-repo/semantics/restrictedAccess
dc.subject Adolescent en_US
dc.subject Adult en_US
dc.subject Female en_US
dc.subject Humans en_US
dc.subject Male en_US
dc.subject Young Adult en_US
dc.subject Child en_US
dc.subject Aged en_US
dc.subject Aged, 80 and over en_US
dc.subject Middle Aged en_US
dc.subject Treatment Outcome en_US
dc.subject Biomarkers en_US
dc.subject Pilot Projects en_US
dc.subject Real-Time Polymerase Chain Reaction en_US
dc.subject Amphotericin B/administration & dosage/therapeutic use en_US
dc.subject Antimony Sodium Gluconate/administration & dosage/therapeutic use en_US
dc.subject DNA, Kinetoplast/genetics en_US
dc.subject DNA, Protozoan/genetics/isolation & purification en_US
dc.subject Leishmaniasis, Mucocutaneous/parasitology en_US
dc.title Quantitative Kinetoplast DNA Assessment During Treatment of Mucosal Leishmaniasis as a Potential Biomarker of Outcome: A Pilot Study en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.4269/ajtmh.15-0514
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.06
dc.relation.issn 1476-1645


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