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dc.contributor.authorCastro, Alicia
dc.contributor.authorCarrillo, Eugenia 
dc.contributor.authorSan Martín, Juan V
dc.contributor.authorBotana, Laura 
dc.contributor.authorMolina, Laura
dc.contributor.authorMatía, Belén
dc.contributor.authorFernandez, Laura 
dc.contributor.authorHorrillo, Luis
dc.contributor.authorIbarra-Meneses, Ana Victoria 
dc.contributor.authorSanchez Herrero, Carmen 
dc.contributor.authorRuiz-Giardin, Jose M
dc.contributor.authorMoreno, Javier
dc.identifier.citationActa Trop. 2016 Dec;164:345-351.es_ES
dc.description.abstractThe introduction of HAART resulted in the decrease of Leishmania/HIV co-infection cases; nevertheless, the number of relapses remains high and secondary prophylaxis is recommended. However, secondary prophylaxis is not necessary in all patients, and presents a high risk of toxicity and an elevated cost. Our aim was to study whether specific cellular response to Leishmania infantum (measured by cell proliferation response after stimulation with soluble Leishmania antigen (SLA)), could be a useful tool to attempt a secondary prophylaxis withdrawal. In June 2009 an outbreak of leishmaniasis by Leishmania infantum was declared in the southeast of Madrid, and since January 2013, we recruited 10 HIV+ patients that had been treated for visceral leishmaniasis. 6 patients had positive SLA-cell proliferation test. The mean CD4 cell counts of those patients with positive SLA were 140 cel/mm3 and 40 cel/mm3 in those with negative SLA test. 3 patients with positive SLA-cell proliferation test (CD4 count: 336, 307, 625) were not on prophylaxis, and the other 3 patients (CD4 count: 152, 189, 359) were on secondary prophylaxis that was withdrawn after the positive SLA-cell proliferation test with no posterior relapses (mean follow up 60 weeks). From the 4 patients, which had negative SLA-cell proliferation test and continued on prophylaxis, 3 had positive PCR for Leishmania at the end of the follow-up and 2 presented clinical relapses. The performance of SLA-cell proliferation test can be a useful tool that can permit us to try withdrawal of the prophylaxis in Leishmania/HIV co-infected patients with low CD4+ counts under clinical supervision, diminishing risk of toxicity and cost.es_ES
dc.description.sponsorshipThis study received financial support from the ‘Red de Investigación Cooperativa en Enfermedades Tropicales (RICET + RD12/0018/0008), VI PN de I + D + I 2008–2011, ISCIII— Subdirección General de Redes y Centros de Investigación Cooperativa; y fondos FEDER, and from ISCIII-AES project Impact of leishmaniasis outbreak in the southwest of Madrid in the immunosuppressed population (PI13/00440). EC was supported by a research contract funded via VII PN I + D + I 2013–2016 and FEDER Funds (RICET RD12/0018/0003).es_ES
dc.publisherElsevier es_ES
dc.subjectLymphoproliferative responsees_ES
dc.subjectVisceral leishmaniasises_ES
dc.subject.meshAdolescent es_ES
dc.subject.meshAdult es_ES
dc.subject.meshAntigens, Protozoan es_ES
dc.subject.meshCD4 Lymphocyte Count es_ES
dc.subject.meshChronic Disease es_ES
dc.subject.meshCoinfection es_ES
dc.subject.meshFemale es_ES
dc.subject.meshHIV Infections es_ES
dc.subject.meshHumans es_ES
dc.subject.meshLeishmania infantum es_ES
dc.subject.meshLeishmaniasis, Visceral es_ES
dc.subject.meshMale es_ES
dc.subject.meshMiddle Aged es_ES
dc.subject.meshRecurrence es_ES
dc.titleLymphoproliferative response after stimulation with soluble leishmania antigen (SLA) as a predictor of visceral leishmaniasis (VL) relapse in HIV+ patients.es_ES
dc.typejournal articlees_ES
dc.rights.licenseAttribution-NonCommercial-NoDerivatives 4.0 Internacional*
dc.contributor.funderRed de Investigación Cooperativa en Enfermedades Tropicales (España) es_ES
dc.contributor.funderInstituto de Salud Carlos III es_ES
dc.contributor.funderUnión Europea. Fondo Europeo de Desarrollo Regional (FEDER/ERDF) es_ES
dc.identifier.journalActa Tropicaes_ES
dc.relation.projectIDinfo:eu-repo/grantAgreement/ES/RICET + RD12/0018/0008es_ES
dc.relation.projectIDinfo:eu-repo/grantAgreement/ES/RICET RD12/0018/0003es_ES
dc.rights.accessRightsopen accesses_ES

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Attribution-NonCommercial-NoDerivatives 4.0 Internacional
This item is licensed under a: Attribution-NonCommercial-NoDerivatives 4.0 Internacional