The Risk Factors for and Effects of Visceral Leishmaniasis in Graft and Renal Transplant Recipients

Abstract

Cytomegalovirus infection after transplantation and living with cats increased the risk of VL in renal transplant recipients living in VL endemic areas.

Risk factors, clinical features and outcomes of visceral leishmaniasis in solid-organ transplant recipients: a retrospective multicenter case–control study

“…It is worth mentioning that the incidence of VL in Brazil ranges from low to high and from no transmission to intense transmission, depending on location [11]. The frequency of disease among SOT recipients from endemic zones may also depend on the socioeconomic level of the population, and in nonendemic countries, VL should be considered in immigrants arriving from endemic zones [12,13]. In this study, neither the socioeconomic category nor the degree of exposure of the recipient was evaluated.…”

“…Additionally, serologic methods can exhibit a lack of agreement. Furthermore, the sensitivity is variable, and specificity can be unsatisfactory [4,12,19]. however, serology cannot distinguish between prior exposure and active infection and may presents a cross-reaction with other protozoa [20].…”

Risk Factors Associated With Leishmaniasis

“…Intestinal parasitic infections causing malnutrition and HIV are other risk factors sensitizing people to leishmaniasis [16]. HIV/VL co-infections exist in countries in which leishmaniasis is endemic and the increase in cases of leishmaniasis is widely associated with the spread of HIV [16,28]. In addition to HIV itself, severe malnutrition due to HIV is involved in the increased prevalence of VL [16].…”

“…Immunosuppression is one of the major factors responsible for reactivation of a silent Leishmania infection or for increased susceptibility to the primary infection [16,28]. Immunosuppressed peoples and graft and renal transplant recipients who live with dogs and cats and in VL endemic areas are at high risk for VL after transplantation [28]. Intestinal parasitic infections causing malnutrition and HIV are other risk factors sensitizing people to leishmaniasis [16].…”

“…Presence of these animals, mostly cows, can increase the prevalence of leishmaniasis cases via increasing the density of sand flies around houses, as their dung provides a rich environment for the sand flies, drawing the vectors into closer association with humans and increasing the risk of their being bitten [26,27]. Immunosuppression is one of the major factors responsible for reactivation of a silent Leishmania infection or for increased susceptibility to the primary infection [16,28]. Immunosuppressed peoples and graft and renal transplant recipients who live with dogs and cats and in VL endemic areas are at high risk for VL after transplantation [28].…”