Journal
FRONTIERS IN CELLULAR AND INFECTION MICROBIOLOGY
Volume 11, Issue -, Pages -Publisher
FRONTIERS MEDIA SA
DOI: 10.3389/fcimb.2021.623437
Keywords
anti-leishmanial antibodies; biomarkers; HIV-VL; kinetoplast DNA kDNA; molecular diagnosis; Post Kala-azar Dermal Leishmaniasis PKDL; Visceral Leishmaniasis VL
Categories
Funding
- Indian Council for Medical Research [(6/9-7[151]2017-ECD II)]
- Dept. of Health Research [/SUG-05/2015-16]
- Fund for Improvement of S&T infrastructure in Universities and Higher Educational Institutions (FIST) Program, Dept. of Science and Technology [SR/FST/LS1-663/2016]
- Dept. of Science and Technology [969 [Sanc.], T/9G-22/2016]
- JC Bose Fellowship [JCB/2019/000043]
- Science Engineering & Research Board, DST
- SS a recipient of Junior Research Fellowship
- CSIR, Govt. of India
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With the consolidation phase of the Visceral Leishmaniasis/Kala-azar Elimination Program in South Asia, the focus is on case detection, vector control, and identifying potential sources of infection to curb transmission. Post Kala-azar Dermal Leishmaniasis (PKDL) cases are considered potential disease reservoirs, and immunological tests are gradually replacing tissue aspirates for diagnosis of VL.
With the Visceral Leishmaniasis/Kala-azar Elimination Program in South Asia in its consolidation phase, the focus is mainly on case detection, vector control, and identifying potential sources of infection. Accordingly, emphasis is presently on curbing transmission, which is potentially achievable by identification and elimination of potential reservoirs. The strongest contenders for being the disease reservoir are cases of Post Kala-azar Dermal Leishmaniasis (PKDL) which occurs in a minor proportion of individuals apparently cured of Visceral Leishmaniasis (VL). The demonstration of parasites in tissue aspirates despite being a risky and invasive process is the gold standard for diagnosis of VL, but is now being replaced by serological tests e.g., rK39 strip test and direct agglutination test. However, these antibody based tests are limited in their ability to diagnose relapses, detect cases of PKDL, and monitor effectiveness of treatment. Accordingly, detection of antigen or nucleic acids by polymerase chain reaction has been successfully applied for monitoring of parasite kinetics. This review article provides updated information on recent developments regarding the available antibody or antigen/nucleic acid based biomarkers for longitudinal monitoring of patients with VL or PKDL and emphasizes the need for availability of studies pertaining to quantification of treatment response or relapse.
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