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<p>Jeffrey Shaw wrote:
<blockquote TYPE=CITE>A ProMED-mail post [copy]
<br><<a href="http://www.healthnet.org/programs/promed.html">http://www.healthnet.org/programs/promed.html</a>>
<p>Date: Sun, 7 Nov 1999 18:27:34 +0200
<br>From: "michaeli dan @ micky" <michaeli@netvision.net.il>
<p>The item on coincidence of visceral leismaniasis with HIV infection
is
<br>intriguing. For many years The fact that _L.tropica_ was producing
cutaneous
<br>leishmaniasis in man but in other species would cause muco-cutaneous
disease
<br>(e.g. psamomys) was interpreted as due to different types of
cellular
<br>immune reactions of different species. _L.donovani_ is not producing
the
<br>same reaction in man and this is the explanation for its hematological
<br>spread, thus producing the visceral form of the disease. Now this
<br>association raises, in my mind, the possibility that we may not be
dealing
<br>with _L.donovani_ but maybe with _L.tropica_ that infects a host with
a
<br>modified cellular reaction as the result of the effect of the HIV infection.
<br>Therefore it would be very
<br>interesting to know if in those cases of visceral leishmaniasis that
are
<br>reported in association with HIV infection, the serological type of
the
<br>leishmania was definitely established. Maybe DNA fingerprinting should
be
<br>done in those cases?
<p>Would anybody wish to comment on this idea?
<p>- --
<br>Dan Michaeli
<br>Kupat Holim Clalit
<br>101 Arlozorov st
<br>Tel Aviv 62098, Israel
<br><michaeli@netvision.net.il>
<br>.................................jw</blockquote>
While not specifically related to the question, since it concerns a report
from the New World (Venezuela), the study cited below clearly demonstrated
that visceral manifestations of leishmaniasis were caused in a patient
infected with HIV by a species of <i>Leishmania </i>which is normally
associated with (muco) cutaneous disease:
<br>--Hernández, D., N. Rodríguez, C. Martínez, L.
García and J. Convit (1993) <i>Leishmania braziliensis </i>causing
visceral leishmaniasis in a patient with human immunodeficiency virus infection,
identified with the aid of the polymerase chain reaction. Trans.
Roy. Soc. Trop. Med Hyg 87, 627-628.--
<br>The most obvious interpretation would be that visceralization occurred
because of the absence of an adequate cell-mediated immune response and
failure to localize the infection at the cutaneous level. I don't
have the article at hand--the authors may have suggested other possible
interpretations of their findings.
<p>Marian Ulrich
<br>Instituto de Biomedicina
<br>Caracas, Venezuela</html>