Serosurvey and factors associated with Leishmania donovani infection in febrile HIV infected individuals attending Abuja Teaching Hospital, Nigeria

Abstract

Background: Leishmania Donovani (L. donovani) is an obligate intracellular pathogen. L. donovani and HIV co-infection is neglected clinical entity in sub-Saharan African. L. donovani infections have been shown to deplete host cellular immunity and proceed to severe diseases. As part of the ongoing research efforts in Nigeria to improve the healthcare of HIV infected individuals through diagnosis and treatment of co-infections with leishmaniasis, this study was instigated.

Methods & Materials: Three hundred and forty blood samples were individually collected from HIV infected individuals with fever>10 days attending University of Abuja Teaching Hospital, Nigeria. EDTA anticoagulated blood was tested for CD4+ cell counts, while sera were tested for L. donovanii IgG antibodies using flow cytometry and Enzyme linked immunosorbent Assay (ELISA) respectively. Interviewer-based questionnaires were used to collect participants' sociodemographic  variables. Data were analysed for statistical association and relation between seropositivity of L. donovani IgG and risk factors.

Results: Of the 340 participants studied, the seroprevalence of L. donovanii antibodies was 8.2%. The mean CD4+ cell count of those with L. donovani seropositivity (n = 28) was 119.4cells/mm³. There was statistical relation between CD4+ cell counts and L. donovani antibodies. There was statistical association between L. donovani IgG seropositivity with age of participants (p = 0.014), residential area (p = 0.033), living condition (p = 0.0006) and Proximity to water collection (p<0.0006) and bushes/ vegetation (p=0.049). Skin disfiguration was
significantly associated with L. donovani IgG antibodies (p=0.000).

Conclusion: Findings from this study revealed that L. donovani is an etiological agent of acute fever and skin disfiguration in HIV infected patients and significantly associated with CD4+ lymphopaenia in HIVco-infectedpatients.

Keywords: Leishmaniasis; HIV coinfections; Surveillance; Cellular immunity