{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T11:03:48Z","timestamp":1767179028921,"version":"build-2238731810"},"update-to":[{"DOI":"10.1371\/journal.pntd.0009067","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2021,2,2]],"date-time":"2021-02-02T00:00:00Z","timestamp":1612224000000}}],"reference-count":33,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2021,1,21]],"date-time":"2021-01-21T00:00:00Z","timestamp":1611187200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"\n Background<\/jats:title>\n \n Visceral leishmaniasis (VL) in HIV-positive individuals is a global health problem. HIV-\n Leishmania<\/jats:italic>\n coinfection worsens prognosis and mortality risk, and HIV-\n Leishmania<\/jats:italic>\n coinfected individuals are more susceptible to VL relapses. Early initiation of antiretroviral therapy can protect against\n Leishmania<\/jats:italic>\n infection in individuals living in VL-endemic areas, and regular use of antiretrovirals might prevent VL relapses in these individuals. We conducted a cross-sectional study in Petrolina, Brazil, an VL-endemic area, to estimate the prevalence of asymptomatic\n Leishmania<\/jats:italic>\n cases among HIV-positive outpatients.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We invited any HIV-positive patients, aged \u2265 18-years-old, under antiretroviral therapy, and who were asymptomatic for VL. Patients were tested for\n Leishmania<\/jats:italic>\n with enzyme-linked immunosorbent assays (ELISA)-rK39, immunochromatographic test (ICT)-rK39, direct agglutination test (DAT), latex agglutination test (KAtex), and conventional polymerase chain reaction (PCR). HIV-\n Leishmania<\/jats:italic>\n coinfection was diagnosed when at least one VL test was positive.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 483 patients were included. The sample was predominantly composed of single, < 48-years-old, black\/\n pardo<\/jats:italic>\n , heterosexual males, with fewer than 8 years of schooling. The prevalence of asymptomatic HIV-\n Leishmania<\/jats:italic>\n coinfection was 9.11% (44\/483). HIV mono-infected and HIV-\n Leishmania<\/jats:italic>\n coinfected groups differed statistically significantly in terms of race (p = 0.045), marital status (p = 0.030), and HIV viral load (p = 0.046). Black\/\n pardo<\/jats:italic>\n patients, married patients, and those with an HIV viral load up to 100,000 copies\/ml presented higher odds for HIV-\n Leishmania<\/jats:italic>\n coinfection.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n A considerable number of asymptomatic\n Leishmania<\/jats:italic>\n cases were observed among HIV-positive individuals in a VL-endemic area. Given the potential impact on transmission and health costs, as well as the impact on these coinfected individuals, studies of asymptomatic\n Leishmania<\/jats:italic>\n carriers can be useful for guiding public health policies in VL-endemic areas aiming to control and eliminate the disease.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1371\/journal.pntd.0009067","type":"journal-article","created":{"date-parts":[[2021,1,21]],"date-time":"2021-01-21T13:28:04Z","timestamp":1611235684000},"page":"e0009067","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":12,"title":["Asymptomatic Leishmania infection in HIV-positive outpatients on antiretroviral therapy in Pernambuco, Brazil"],"prefix":"10.1371","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1907-315X","authenticated-orcid":true,"given":"Diego Lins","family":"Guedes","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8470-9380","authenticated-orcid":true,"given":"Alda Maria","family":"Justo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8301-6600","authenticated-orcid":true,"given":"Walter Lins","family":"Barbosa J\u00fanior","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5119-3920","authenticated-orcid":true,"given":"Elis Dion\u00edsio da","family":"Silva","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6057-0414","authenticated-orcid":true,"given":"Samuel Ricarte de","family":"Aquino","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0146-7123","authenticated-orcid":true,"given":"Manoel Sebastiao da Costa","family":"Lima Junior","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8967-5693","authenticated-orcid":true,"given":"Ulisses","family":"Montarroyos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7434-3223","authenticated-orcid":true,"given":"Gilberto Silva Nunes","family":"Bezerra","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3724-9112","authenticated-orcid":true,"given":"Amanda Virginia Batista","family":"Vieira","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Val\u00e9ria R\u00eago Alves","family":"Pereira","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4434-955X","authenticated-orcid":true,"given":"Zulma Maria de","family":"Medeiros","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2021,1,21]]},"reference":[{"key":"pntd.0009067.ref001","doi-asserted-by":"crossref","first-page":"489","DOI":"10.4269\/ajtmh.15-0408","article-title":"Social and Economic Burden of Human Leishmaniasis","volume":"94","author":"I Okwor","year":"2016","journal-title":"Am J Trop Med Hyg"},{"key":"pntd.0009067.ref002","doi-asserted-by":"crossref","first-page":"e35671","DOI":"10.1371\/journal.pone.0035671","article-title":"Leishmaniasis Worldwide and Global Estimates of Its Incidence","volume":"7","author":"J Alvar","year":"2012","journal-title":"PLoS One"},{"key":"pntd.0009067.ref003","unstructured":"WHO. 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