ArticleTropical medicine and health2025
Screening for Leishmania spp. infection in patients treated with biologic agents for immune-mediated inflammatory diseases: results of an Italian multicentric prospective study.
Article in Tropical medicine and health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundEscalation in the use of biologic agents including tumor necrosis factor (TNF)-α inhibitors to treat immune-mediated inflammatory diseases (IMID) is linked to higher susceptibility of severe infections caused by intracellular pathogens, including Leishmania.
methodsThis multicentric prospective study assessed the presence of Leishmania spp. infection among patients with IMID under treatment with biologic agents in two Italian clinical centers. We utilized a combination of diagnostic tests: real-time PCR for the detection of parasitic kinetoplast DNA in peripheral blood, Western blot for the identification of serum IgG antibodies, and a Whole blood assay to assess cytokine and chemokine responses following stimulation with parasitic antigen.
resultsA total of 126 patients residing in Italy were enrolled. Patients testing positive in at least one assay were classified as Leishmania-positive. Of the 125 asymptomatic individuals, 25 (20%) tested positive for Leishmania infection, revealing a significant rate of subclinical infection. The most frequent marker of infection was positive serology (15/126, 12%) followed by a detectable cell-mediated immune response (9/125, 7%). Parasitic DNA was detected in 3 patients (2%).
conclusionsThis study showed a high prevalence of asymptomatic Leishmania infection in Italian patients with IMID under treatment with biologic agents, with a north-to-south gradient. Given the risk of disease reactivation, these patients may benefit from close monitoring. Further research is warranted to clarify the clinical implications of these findings.
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