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Infection of sand flies by humans coinfected with Leishmania infantum and human immunodeficiency virus.
R Molina
R Molina
Laboratorio de Referencia de Leishmaniasis, Centro Nacional de MicrobiologÃa, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain.
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J M Lohse
J M Lohse
Laboratorio de Referencia de Leishmaniasis, Centro Nacional de MicrobiologÃa, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain.
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F Pulido
F Pulido
Laboratorio de Referencia de Leishmaniasis, Centro Nacional de MicrobiologÃa, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain.
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F Laguna
F Laguna
Laboratorio de Referencia de Leishmaniasis, Centro Nacional de MicrobiologÃa, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain.
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R López-Vélez
R López-Vélez
Laboratorio de Referencia de Leishmaniasis, Centro Nacional de MicrobiologÃa, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain.
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J Alvar
J Alvar
Laboratorio de Referencia de Leishmaniasis, Centro Nacional de MicrobiologÃa, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain.
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To determine the role that Leishmania infantum/human immunodeficiency virus (HIV) coinfected patients could play in the epidemiology of visceral leishmaniasis (VL), we applied direct xenodiagnosis of VL in this study to test the infectivity of six coinfected patients to colonized Phlebotomus perniciosus. All patients proved to be infective for the sand flies. The infectivity of patients who had still not received specific treatment for VL was inversely proportional to their absolute CD4+ T lymphocyte cell count. It has been proven that P. perniciosus can acquire and allow the development of L. infantum by feeding on L. infantum/HIV coinfected patients. Since this sand fly is an important vector of VL in southern Europe, a new natural anthroponotic cycle could be considered in the epidemiology of L. infantum/HIV coinfection. The design of leishmaniasis control programs and the management of coinfected individuals should take these findings into account.
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