Visceral Leishmaniasis-Human Immunodeficiency Virus-Coinfected Patients Are Highly Infectious to Sandflies in an Endemic Area in India

J Infect Dis. 2024 Jun 14;229(6):1909-1912. doi: 10.1093/infdis/jiae156.

Abstract

In an area endemic with Indian visceral leishmaniasis (VL), we performed direct xenodiagnosis to evaluate the transmission of Leishmania donovani from patients with VL-human immunodeficiency virus (HIV) coinfection to the vector sandflies, Phlebotomus argentipes. Fourteen patients with confirmed VL-HIV coinfection, with a median parasitemia of 42 205 parasite genome/mL of blood, were exposed to 732 laboratory-reared pathogen-free female P argentipes sandflies on their lower arms and legs. Microscopy revealed that 16.66% (122/732) of blood-fed flies were xenodiagnosis positive. Notably, 93% (13/14) of the VL-HIV group infected the flies, as confirmed by quantitative polymerase chain reaction and/or microscopy, and were 3 times more infectious than those who had VL without HIV.

Keywords: VL-HIV coinfection; transmission; visceral leishmaniasis; xenodiagnosis.

MeSH terms

  • Adolescent
  • Adult
  • Animals
  • Coinfection* / epidemiology
  • Coinfection* / parasitology
  • Coinfection* / virology
  • Endemic Diseases
  • Female
  • HIV Infections* / complications
  • HIV Infections* / epidemiology
  • Humans
  • India / epidemiology
  • Insect Vectors / parasitology
  • Insect Vectors / virology
  • Leishmania donovani* / isolation & purification
  • Leishmaniasis, Visceral* / complications
  • Leishmaniasis, Visceral* / epidemiology
  • Male
  • Middle Aged
  • Phlebotomus / parasitology
  • Phlebotomus / virology
  • Xenodiagnosis
  • Young Adult