Exposição à picada de Lutzomyia spp. e à Leishmania spp. em indivíduos de área endêmica para leishmaniose visceral no Brasil
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Data
2018-07-17
Autores
Hirata, Karina Yukie
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Universidade Estadual Paulista (Unesp)
Resumo
O presente estudo teve como objetivos investigar a presença de anticorpos anti-Leishmania spp. e anti-saliva de Lutzomyia spp., e a presença do DNA de Leishmania spp. no sangue periférico de 284 indivíduos atendidos em um hospital público de área endêmica para leishmaniose visceral (LV). Baseando-se nos resultados de sorologia e da reação em cadeia da polimerase (PCR), 21,1% dos indivíduos foram considerados expostos. A presença de anticorpos anti-Leishmania spp. e anti-saliva de Lutzomyia spp. foi observada em 20,8% e 37,7% dos indivíduos, respectivamente, observando-se uma associação significativa entre a presença dos dois anticorpos. Em 20,4% dos indivíduos verificou-se sororeatividade em ambos os testes, 17,3% apresentavam anticorpos anti-saliva de Lutzomyia spp. sem a presença de anticorpos anti-Leishmania spp. e um indivíduo apresentava somente anticorpos anti-Leishmania spp. sem a presença de anticorpos anti-saliva de flebotomíneo. Em apenas um indivíduo foi possível amplificar fragmento do DNA de Leishmania spp. no sangue periférico. Concluiu-se que a infecção por Leishmania spp. pode estar sendo subdiagnosticada em áreas endêmicas para LV e, portanto, sugere-se que indivíduos atendidos em hospitais sejam melhor avaliados quanto à possibilidade de infecção e posterior desenvolvimento da doença. Ainda, a presença de anticorpos anti-saliva de flebotomíneo pode ser um possível indicador de exposição ao vetor.
The present study aimed to investigate the presence of anti-Leishmania spp. and anti-saliva of Lutzomyia spp. antibodies, and the presence of Leishmania spp. DNA in the peripheral blood of 284 people attended at a public hospital in an endemic area for visceral leishmaniasis (VL). Based on the results of serology and PCR, 21.1% of the people were considered exposed. The presence of antibodies anti-Leishmania spp. and anti-saliva of Lutzomyia spp. was observed in 20.8% and 37.7% of the individuals, respectively, with a significant association between the presence of both antibodies. In 20.4% of the people there was serum reactivity in both tests, 17.3% had antibodies anti-saliva of Lutzomyia spp. without the presence of anti-Leishmania spp. antibodies, while one individual had only anti-Leishmania spp. antibodies without the presence of antibodies against saliva of sand flies. In only one individual it was possible to amplify the DNA fragment of Leishmania spp. in peripheral blood. It was concluded that the infection by Leishmania spp. may be underdiagnosed in endemic areas for VL and, therefore, it is suggested that people referred to hospitals should be better evaluated for the possibility of infection and subsequent development of the disease. Furthermore, the presence of antibodies anti-sandfly saliva may be an indicator of exposure to vector.
The present study aimed to investigate the presence of anti-Leishmania spp. and anti-saliva of Lutzomyia spp. antibodies, and the presence of Leishmania spp. DNA in the peripheral blood of 284 people attended at a public hospital in an endemic area for visceral leishmaniasis (VL). Based on the results of serology and PCR, 21.1% of the people were considered exposed. The presence of antibodies anti-Leishmania spp. and anti-saliva of Lutzomyia spp. was observed in 20.8% and 37.7% of the individuals, respectively, with a significant association between the presence of both antibodies. In 20.4% of the people there was serum reactivity in both tests, 17.3% had antibodies anti-saliva of Lutzomyia spp. without the presence of anti-Leishmania spp. antibodies, while one individual had only anti-Leishmania spp. antibodies without the presence of antibodies against saliva of sand flies. In only one individual it was possible to amplify the DNA fragment of Leishmania spp. in peripheral blood. It was concluded that the infection by Leishmania spp. may be underdiagnosed in endemic areas for VL and, therefore, it is suggested that people referred to hospitals should be better evaluated for the possibility of infection and subsequent development of the disease. Furthermore, the presence of antibodies anti-sandfly saliva may be an indicator of exposure to vector.
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Palavras-chave
anticorpos, imunidade humoral, reação em cadeia da polimerase em tempo real, sorologia, antibodies, humoral immunity, real-time polymerase chain reaction, saliva, serology