{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T04:15:13Z","timestamp":1783484113462,"version":"3.55.0"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2024,1,9]],"date-time":"2024-01-09T00:00:00Z","timestamp":1704758400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Institute for Tropical Medicine Antwerp\u2019s SOFI"},{"name":"Department of Economy, Science and Innovation of the Flemish government"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,7,19]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>People with human immunodeficiency virus (PWH) with recurrent visceral leishmaniasis (VL) could potentially drive Leishmania transmission in areas with anthroponotic transmission such as East Africa, but studies are lacking. Leishmania parasitemia has been used as proxy for infectiousness.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This study is nested within the Predicting Visceral Leishmaniasis in HIV-InfectedPatients (PreLeisH) prospective cohort study, following 490 PWH free of VL at enrollment for up to 24\u201337 months in northwest Ethiopia. Blood Leishmania polymerase chain reaction (PCR) was done systematically. This case series reports on 10 PWH with chronic VL (\u22653 VL episodes during follow-up) for up to 37 months, and 3 individuals with asymptomatic Leishmania infection for up to 24 months.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>All 10 chronic VL cases were male, on antiretroviral treatment, with 0\u201311 relapses before enrollment. Median baseline CD4 count was 82\u2005cells\/\u00b5L. They displayed 3\u20136 VL treatment episodes over a period up to 37 months. Leishmania blood PCR levels were strongly positive for almost the entire follow-up (median cycle threshold value, 26 [interquartile range, 23\u201330]), including during periods between VL treatment. Additionally, we describe 3 PWH with asymptomatic Leishmania infection and without VL history, with equally strong Leishmania parasitemia over a period of up to 24 months without developing VL. All were on antiretroviral treatment at enrollment, with baseline CD4 counts ranging from 78 to 350\u2005cells\/\u00b5L.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>These are the first data on chronic parasitemia in PWH from Leishmania donovani\u2013endemic areas. PWH with asymptomatic and symptomatic Leishmania infection could potentially be highly infectious and constitute Leishmania superspreaders. Xenodiagnosis studies are required to confirm infectiousness.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciae002","type":"journal-article","created":{"date-parts":[[2024,1,9]],"date-time":"2024-01-09T14:34:18Z","timestamp":1704810858000},"page":"240-246","source":"Crossref","is-referenced-by-count":2,"title":["Chronic High-Level Parasitemia in HIV\u2013Infected Individuals With or Without Visceral Leishmaniasis in an Endemic Area in Northwest Ethiopia: Potential Superspreaders?"],"prefix":"10.1093","volume":"79","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6581-2964","authenticated-orcid":false,"given":"Johan","family":"van Griensven","sequence":"first","affiliation":[{"name":"Department of Clinical Sciences, Institute of Tropical Medicine , Antwerp , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saskia","family":"van Henten","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Institute of Tropical Medicine 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