Tegumentary leishmaniasis and coinfections other than HIV
Tegumentary leishmaniasis (TL) is a disease of skin and/or mucosal tissues caused by Leishmania parasites. TL patients may concurrently carry other pathogens, which may influence the clinical outcome of TL. This review focuses on the frequency of TL coinfections in human populations, interactions be...
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| Published in | PLoS neglected tropical diseases Vol. 12; no. 3; p. e0006125 |
|---|---|
| Main Authors | , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
Public Library of Science
01.03.2018
Public Library of Science (PLoS) |
| Subjects | |
| Online Access | Get full text |
| ISSN | 1935-2735 1935-2727 1935-2735 |
| DOI | 10.1371/journal.pntd.0006125 |
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| Abstract | Tegumentary leishmaniasis (TL) is a disease of skin and/or mucosal tissues caused by Leishmania parasites. TL patients may concurrently carry other pathogens, which may influence the clinical outcome of TL.
This review focuses on the frequency of TL coinfections in human populations, interactions between Leishmania and other pathogens in animal models and human subjects, and implications of TL coinfections for clinical practice. For the purpose of this review, TL is defined as all forms of cutaneous (localised, disseminated, or diffuse) and mucocutaneous leishmaniasis. Human immunodeficiency virus (HIV) coinfection, superinfection with skin bacteria, and skin manifestations of visceral leishmaniasis are not included. We searched MEDLINE and other databases and included 73 records: 21 experimental studies in animals and 52 studies about human subjects (mainly cross-sectional and case studies). Several reports describe the frequency of Trypanosoma cruzi coinfection in TL patients in Argentina (about 41%) and the frequency of helminthiasis in TL patients in Brazil (15% to 88%). Different hypotheses have been explored about mechanisms of interaction between different microorganisms, but no clear answers emerge. Such interactions may involve innate immunity coupled with regulatory networks that affect quality and quantity of acquired immune responses. Diagnostic problems may occur when concurrent infections cause similar lesions (e.g., TL and leprosy), when different pathogens are present in the same lesions (e.g., Leishmania and Sporothrix schenckii), or when similarities between phylogenetically close pathogens affect accuracy of diagnostic tests (e.g., serology for leishmaniasis and Chagas disease). Some coinfections (e.g., helminthiasis) appear to reduce the effectiveness of antileishmanial treatment, and drug combinations may cause cumulative adverse effects.
In patients with TL, coinfection is frequent, it can lead to diagnostic errors and delays, and it can influence the effectiveness and safety of treatment. More research is needed to unravel how coinfections interfere with the pathogenesis of TL. |
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| AbstractList | Tegumentary leishmaniasis (TL) is a disease of skin and/or mucosal tissues caused by Leishmania parasites. TL patients may concurrently carry other pathogens, which may influence the clinical outcome of TL.
This review focuses on the frequency of TL coinfections in human populations, interactions between Leishmania and other pathogens in animal models and human subjects, and implications of TL coinfections for clinical practice. For the purpose of this review, TL is defined as all forms of cutaneous (localised, disseminated, or diffuse) and mucocutaneous leishmaniasis. Human immunodeficiency virus (HIV) coinfection, superinfection with skin bacteria, and skin manifestations of visceral leishmaniasis are not included. We searched MEDLINE and other databases and included 73 records: 21 experimental studies in animals and 52 studies about human subjects (mainly cross-sectional and case studies). Several reports describe the frequency of Trypanosoma cruzi coinfection in TL patients in Argentina (about 41%) and the frequency of helminthiasis in TL patients in Brazil (15% to 88%). Different hypotheses have been explored about mechanisms of interaction between different microorganisms, but no clear answers emerge. Such interactions may involve innate immunity coupled with regulatory networks that affect quality and quantity of acquired immune responses. Diagnostic problems may occur when concurrent infections cause similar lesions (e.g., TL and leprosy), when different pathogens are present in the same lesions (e.g., Leishmania and Sporothrix schenckii), or when similarities between phylogenetically close pathogens affect accuracy of diagnostic tests (e.g., serology for leishmaniasis and Chagas disease). Some coinfections (e.g., helminthiasis) appear to reduce the effectiveness of antileishmanial treatment, and drug combinations may cause cumulative adverse effects.
In patients with TL, coinfection is frequent, it can lead to diagnostic errors and delays, and it can influence the effectiveness and safety of treatment. More research is needed to unravel how coinfections interfere with the pathogenesis of TL. Background Tegumentary leishmaniasis (TL) is a disease of skin and/or mucosal tissues caused by Leishmania parasites. TL patients may concurrently carry other pathogens, which may influence the clinical outcome of TL. Methodology and principal findings This review focuses on the frequency of TL coinfections in human populations, interactions between Leishmania and other pathogens in animal models and human subjects, and implications of TL coinfections for clinical practice. For the purpose of this review, TL is defined as all forms of cutaneous (localised, disseminated, or diffuse) and mucocutaneous leishmaniasis. Human immunodeficiency virus (HIV) coinfection, superinfection with skin bacteria, and skin manifestations of visceral leishmaniasis are not included. We searched MEDLINE and other databases and included 73 records: 21 experimental studies in animals and 52 studies about human subjects (mainly cross-sectional and case studies). Several reports describe the frequency of Trypanosoma cruzi coinfection in TL patients in Argentina (about 41%) and the frequency of helminthiasis in TL patients in Brazil (15% to 88%). Different hypotheses have been explored about mechanisms of interaction between different microorganisms, but no clear answers emerge. Such interactions may involve innate immunity coupled with regulatory networks that affect quality and quantity of acquired immune responses. Diagnostic problems may occur when concurrent infections cause similar lesions (e.g., TL and leprosy), when different pathogens are present in the same lesions (e.g., Leishmania and Sporothrix schenckii), or when similarities between phylogenetically close pathogens affect accuracy of diagnostic tests (e.g., serology for leishmaniasis and Chagas disease). Some coinfections (e.g., helminthiasis) appear to reduce the effectiveness of antileishmanial treatment, and drug combinations may cause cumulative adverse effects. Conclusions and significance In patients with TL, coinfection is frequent, it can lead to diagnostic errors and delays, and it can influence the effectiveness and safety of treatment. More research is needed to unravel how coinfections interfere with the pathogenesis of TL. Background Tegumentary leishmaniasis (TL) is a disease of skin and/or mucosal tissues caused by Leishmania parasites. TL patients may concurrently carry other pathogens, which may influence the clinical outcome of TL. Methodology and principal findings This review focuses on the frequency of TL coinfections in human populations, interactions between Leishmania and other pathogens in animal models and human subjects, and implications of TL coinfections for clinical practice. For the purpose of this review, TL is defined as all forms of cutaneous (localised, disseminated, or diffuse) and mucocutaneous leishmaniasis. Human immunodeficiency virus (HIV) coinfection, superinfection with skin bacteria, and skin manifestations of visceral leishmaniasis are not included. We searched MEDLINE and other databases and included 73 records: 21 experimental studies in animals and 52 studies about human subjects (mainly cross-sectional and case studies). Several reports describe the frequency of Trypanosoma cruzi coinfection in TL patients in Argentina (about 41%) and the frequency of helminthiasis in TL patients in Brazil (15% to 88%). Different hypotheses have been explored about mechanisms of interaction between different microorganisms, but no clear answers emerge. Such interactions may involve innate immunity coupled with regulatory networks that affect quality and quantity of acquired immune responses. Diagnostic problems may occur when concurrent infections cause similar lesions (e.g., TL and leprosy), when different pathogens are present in the same lesions (e.g., Leishmania and Sporothrix schenckii), or when similarities between phylogenetically close pathogens affect accuracy of diagnostic tests (e.g., serology for leishmaniasis and Chagas disease). Some coinfections (e.g., helminthiasis) appear to reduce the effectiveness of antileishmanial treatment, and drug combinations may cause cumulative adverse effects. Conclusions and significance In patients with TL, coinfection is frequent, it can lead to diagnostic errors and delays, and it can influence the effectiveness and safety of treatment. More research is needed to unravel how coinfections interfere with the pathogenesis of TL. Infectious diseases are often studied one by one, but people can have more than one infection at the same time. This is likely to happen when different microorganisms are linked to specific geographical regions or living conditions. In this paper, we summarise the literature about infections occurring together with tegumentary leishmaniasis (TL), a disease of skin and mucosal tissues that is caused by Leishmania parasites. We found that in Latin America, patients with TL are often also infected with helminths or with Trypanosoma cruzi (the parasite that causes Chagas disease). Information from other parts of the world is scarce. Animal studies and observations in humans show that one infection can change the course of another infection, but how this happens is not well understood. When different infections affect the same patient at the same time, the diagnosis can be difficult, especially when different microorganisms are biologically similar, when they cause similar lesions, or when they are present in the same lesions. Treatment can also be difficult because some coinfections reduce the efficacy of the treatment against Leishmania and because some drug combinations can lead to cumulative adverse effects. Tegumentary leishmaniasis (TL) is a disease of skin and/or mucosal tissues caused by Leishmania parasites. TL patients may concurrently carry other pathogens, which may influence the clinical outcome of TL.This review focuses on the frequency of TL coinfections in human populations, interactions between Leishmania and other pathogens in animal models and human subjects, and implications of TL coinfections for clinical practice. For the purpose of this review, TL is defined as all forms of cutaneous (localised, disseminated, or diffuse) and mucocutaneous leishmaniasis. Human immunodeficiency virus (HIV) coinfection, superinfection with skin bacteria, and skin manifestations of visceral leishmaniasis are not included. We searched MEDLINE and other databases and included 73 records: 21 experimental studies in animals and 52 studies about human subjects (mainly cross-sectional and case studies). Several reports describe the frequency of Trypanosoma cruzi coinfection in TL patients in Argentina (about 41%) and the frequency of helminthiasis in TL patients in Brazil (15% to 88%). Different hypotheses have been explored about mechanisms of interaction between different microorganisms, but no clear answers emerge. Such interactions may involve innate immunity coupled with regulatory networks that affect quality and quantity of acquired immune responses. Diagnostic problems may occur when concurrent infections cause similar lesions (e.g., TL and leprosy), when different pathogens are present in the same lesions (e.g., Leishmania and Sporothrix schenckii), or when similarities between phylogenetically close pathogens affect accuracy of diagnostic tests (e.g., serology for leishmaniasis and Chagas disease). Some coinfections (e.g., helminthiasis) appear to reduce the effectiveness of antileishmanial treatment, and drug combinations may cause cumulative adverse effects.In patients with TL, coinfection is frequent, it can lead to diagnostic errors and delays, and it can influence the effectiveness and safety of treatment. More research is needed to unravel how coinfections interfere with the pathogenesis of TL. Tegumentary leishmaniasis (TL) is a disease of skin and/or mucosal tissues caused by Leishmania parasites. TL patients may concurrently carry other pathogens, which may influence the clinical outcome of TL.BACKGROUNDTegumentary leishmaniasis (TL) is a disease of skin and/or mucosal tissues caused by Leishmania parasites. TL patients may concurrently carry other pathogens, which may influence the clinical outcome of TL.This review focuses on the frequency of TL coinfections in human populations, interactions between Leishmania and other pathogens in animal models and human subjects, and implications of TL coinfections for clinical practice. For the purpose of this review, TL is defined as all forms of cutaneous (localised, disseminated, or diffuse) and mucocutaneous leishmaniasis. Human immunodeficiency virus (HIV) coinfection, superinfection with skin bacteria, and skin manifestations of visceral leishmaniasis are not included. We searched MEDLINE and other databases and included 73 records: 21 experimental studies in animals and 52 studies about human subjects (mainly cross-sectional and case studies). Several reports describe the frequency of Trypanosoma cruzi coinfection in TL patients in Argentina (about 41%) and the frequency of helminthiasis in TL patients in Brazil (15% to 88%). Different hypotheses have been explored about mechanisms of interaction between different microorganisms, but no clear answers emerge. Such interactions may involve innate immunity coupled with regulatory networks that affect quality and quantity of acquired immune responses. Diagnostic problems may occur when concurrent infections cause similar lesions (e.g., TL and leprosy), when different pathogens are present in the same lesions (e.g., Leishmania and Sporothrix schenckii), or when similarities between phylogenetically close pathogens affect accuracy of diagnostic tests (e.g., serology for leishmaniasis and Chagas disease). Some coinfections (e.g., helminthiasis) appear to reduce the effectiveness of antileishmanial treatment, and drug combinations may cause cumulative adverse effects.METHODOLOGY AND PRINCIPAL FINDINGSThis review focuses on the frequency of TL coinfections in human populations, interactions between Leishmania and other pathogens in animal models and human subjects, and implications of TL coinfections for clinical practice. For the purpose of this review, TL is defined as all forms of cutaneous (localised, disseminated, or diffuse) and mucocutaneous leishmaniasis. Human immunodeficiency virus (HIV) coinfection, superinfection with skin bacteria, and skin manifestations of visceral leishmaniasis are not included. We searched MEDLINE and other databases and included 73 records: 21 experimental studies in animals and 52 studies about human subjects (mainly cross-sectional and case studies). Several reports describe the frequency of Trypanosoma cruzi coinfection in TL patients in Argentina (about 41%) and the frequency of helminthiasis in TL patients in Brazil (15% to 88%). Different hypotheses have been explored about mechanisms of interaction between different microorganisms, but no clear answers emerge. Such interactions may involve innate immunity coupled with regulatory networks that affect quality and quantity of acquired immune responses. Diagnostic problems may occur when concurrent infections cause similar lesions (e.g., TL and leprosy), when different pathogens are present in the same lesions (e.g., Leishmania and Sporothrix schenckii), or when similarities between phylogenetically close pathogens affect accuracy of diagnostic tests (e.g., serology for leishmaniasis and Chagas disease). Some coinfections (e.g., helminthiasis) appear to reduce the effectiveness of antileishmanial treatment, and drug combinations may cause cumulative adverse effects.In patients with TL, coinfection is frequent, it can lead to diagnostic errors and delays, and it can influence the effectiveness and safety of treatment. More research is needed to unravel how coinfections interfere with the pathogenesis of TL.CONCLUSIONS AND SIGNIFICANCEIn patients with TL, coinfection is frequent, it can lead to diagnostic errors and delays, and it can influence the effectiveness and safety of treatment. More research is needed to unravel how coinfections interfere with the pathogenesis of TL. |
| Audience | Academic |
| Author | Polman, Katja Dujardin, Jean-Claude Martínez, Dalila Y. Kaye, Paul M. Llanos-Cuentas, Alejandro Boelaert, Marleen Verdonck, Kristien Adaui, Vanessa |
| AuthorAffiliation | 2 Department of Public Health, Institute of Tropical Medicine Antwerp, Antwerp, Belgium 5 Department of Biomedical Sciences, Institute of Tropical Medicine Antwerp, Antwerp, Belgium 1 Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru 3 Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium 6 Department of Biomedical Sciences, Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, University of Antwerp, Antwerp, Belgium Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, BRAZIL 4 Centre for Immunology and Infection, Department of Biology and Hull York Medical School, University of York, York, United Kingdom |
| AuthorAffiliation_xml | – name: 1 Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru – name: 4 Centre for Immunology and Infection, Department of Biology and Hull York Medical School, University of York, York, United Kingdom – name: Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, BRAZIL – name: 5 Department of Biomedical Sciences, Institute of Tropical Medicine Antwerp, Antwerp, Belgium – name: 2 Department of Public Health, Institute of Tropical Medicine Antwerp, Antwerp, Belgium – name: 3 Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium – name: 6 Department of Biomedical Sciences, Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, University of Antwerp, Antwerp, Belgium |
| Author_xml | – sequence: 1 givenname: Dalila Y. surname: Martínez fullname: Martínez, Dalila Y. – sequence: 2 givenname: Kristien orcidid: 0000-0003-1153-4078 surname: Verdonck fullname: Verdonck, Kristien – sequence: 3 givenname: Paul M. surname: Kaye fullname: Kaye, Paul M. – sequence: 4 givenname: Vanessa surname: Adaui fullname: Adaui, Vanessa – sequence: 5 givenname: Katja surname: Polman fullname: Polman, Katja – sequence: 6 givenname: Alejandro surname: Llanos-Cuentas fullname: Llanos-Cuentas, Alejandro – sequence: 7 givenname: Jean-Claude surname: Dujardin fullname: Dujardin, Jean-Claude – sequence: 8 givenname: Marleen surname: Boelaert fullname: Boelaert, Marleen |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/29494584$$D View this record in MEDLINE/PubMed |
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| ContentType | Journal Article |
| Copyright | COPYRIGHT 2018 Public Library of Science 2018 Public Library of Science. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited: Martínez DY, Verdonck K, Kaye PM, Adaui V, Polman K, Llanos-Cuentas A, et al. (2018) Tegumentary leishmaniasis and coinfections other than HIV. PLoS Negl Trop Dis 12(3): e0006125. https://doi.org/10.1371/journal.pntd.0006125 2018 Martínez et al 2018 Martínez et al 2018 Public Library of Science. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited: Martínez DY, Verdonck K, Kaye PM, Adaui V, Polman K, Llanos-Cuentas A, et al. (2018) Tegumentary leishmaniasis and coinfections other than HIV. PLoS Negl Trop Dis 12(3): e0006125. https://doi.org/10.1371/journal.pntd.0006125 |
| Copyright_xml | – notice: COPYRIGHT 2018 Public Library of Science – notice: 2018 Public Library of Science. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited: Martínez DY, Verdonck K, Kaye PM, Adaui V, Polman K, Llanos-Cuentas A, et al. (2018) Tegumentary leishmaniasis and coinfections other than HIV. PLoS Negl Trop Dis 12(3): e0006125. https://doi.org/10.1371/journal.pntd.0006125 – notice: 2018 Martínez et al 2018 Martínez et al – notice: 2018 Public Library of Science. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited: Martínez DY, Verdonck K, Kaye PM, Adaui V, Polman K, Llanos-Cuentas A, et al. (2018) Tegumentary leishmaniasis and coinfections other than HIV. PLoS Negl Trop Dis 12(3): e0006125. https://doi.org/10.1371/journal.pntd.0006125 |
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| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 ObjectType-Review-3 content type line 23 Conceptualization: DYM, KV, KP, JCD, MB.Data curation: DYM, KV.Formal analysis: DYM, KV.Funding acquisition: JCD, MB.Investigation: DYM, KV, PMK, JCD, MB.Methodology: DYM, KV, PMK, KP, JCD, MB.Project administration: JCD, MB.Resources: ALC, JCD, MB.Supervision: ALC, JCD, MB.Validation: PMK, VA, KP, ALC, JCD, MB.Visualization: DYM, KV.Writing – original draft: DYM, KV, PMK.Writing – review & editing: VA, KP, ALC, JCD, MB. The authors have declared that no competing interests exist. |
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| Snippet | Tegumentary leishmaniasis (TL) is a disease of skin and/or mucosal tissues caused by Leishmania parasites. TL patients may concurrently carry other pathogens,... Background Tegumentary leishmaniasis (TL) is a disease of skin and/or mucosal tissues caused by Leishmania parasites. TL patients may concurrently carry other... Infectious diseases are often studied one by one, but people can have more than one infection at the same time. This is likely to happen when different... Background Tegumentary leishmaniasis (TL) is a disease of skin and/or mucosal tissues caused by Leishmania parasites. TL patients may concurrently carry other... |
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| SubjectTerms | Analysis Animal models Animals Argentina - epidemiology Biology and Life Sciences Brazil - epidemiology Care and treatment Case studies Chagas disease Coinfection - epidemiology Coinfection - parasitology Diagnostic errors Diagnostic systems Disease Models, Animal Helminthiasis HIV Human immunodeficiency virus Human populations Human subjects Humans Immune response Immunity Immunology Infections Infectious diseases Innate immunity Leishmania Leishmaniasis Leishmaniasis, Cutaneous - epidemiology Leprosy Lesions Medicine Medicine and Health Sciences Microbiota Microorganisms Mucocutaneous leishmaniasis Mucosa Parasites Parasitic diseases Pathogenesis Pathogens Patient care Patients Phylogeny Public health Review Safety and security measures Serology Skin Skin - pathology Skin diseases Superinfection Tegumentary leishmaniasis Tropical diseases Trypanosoma cruzi Vector-borne diseases Viruses Visceral leishmaniasis |
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| Title | Tegumentary leishmaniasis and coinfections other than HIV |
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