The isolation of Leishmania donovani mon

Article available at http://www.parasite-journal.org or http://dx.doi.org/10.1051/parasite/1994014391
THE ISOLATION OF LEISHMANIA DONOVANI MON-18, FROM AN AIDS PATIENT
IN PORTUGAL : POSSIBLE NEEDLE TRANSMISSION
CAMPING- L.*, SANTOS-GOMES G.*, PRATLONG F.**, DEDET J.P.* and ABRANCHES P.*
Summary
:
Resume
The spread of HIV infection into leishmaniasis endemic areas has
increased the incidence of immunosupressed patients with kala-
. LEISHMANIA DONOVANI MON-18 ISOLÉ CHEZ UN SIDÉEN AU
PORTUGAL
L'incidence des co-infections Leishmania/VIH augmente au Portugal
azar in Portugal.
depuis l'extension de l'infection VIH aux zones endémiques de kala-
The dermotropic zymodeme MON-24 of Leishmania infantum has
azar dans ce pays.
been already isolated from a Portuguese AIDS patient, as in some
Leishmania infantum MON-24,
other Mediterranean countries.
trope", a déjà été isolé d'un cas de co-infection Leishmania/VIH au
zymodème autochtone "dermo-
In this paper we report the isolation of L. donovani MON-18 from
Portugal.
a drug addicted Portuguese patient with clinical visceral leishma-
Nous rapportons ici un cas similaire dû à L. donovani
niasis and AIDS, that suggests a mechanically transmitted infection
chez un toxicomane portugais dont le mode de contamination pour-
by the use of a shared needle or syringe.
rait s'expliquer par l'usage d'aiguilles ou de seringues contaminées.
KEYWORDS : AIDS. Kala-azar. Zymodeme MON-18. Portugal, L. donovani.
I
n P o r t u g a l Leishmania
infantum
zymodeme
MON-1 h a s b e e n i s o l a t e d from h u m a n s , d o g s ,
foxes (Abranches et al., 1 9 8 6 ) a n d p h l e b o t o m i n e
sandflies (Pires et al, 1 9 9 1 ) . L. infantum
zymodeme
M O N - 2 4 w a s isolated from p h l e b o t o m i n e sandflies
(Pires et al. 1 9 9 1 ) a n d from an i m m u n o s u p r e s s e d
patient ( C a m p i n o et al, 1 9 9 4 ) .
T h e s p r e a d i n g o f H I V i n f e c t i o n into l e i s h m a n i a s i s
e n d e m i c areas has increased the prevalence o f HIVl e i s h m a n i a c o - i n f e c t i o n s in P o r t u g a l a n d in o t h e r
Mediterranean countries including Spain, France a n d
Italy (Peters et al, 1 9 9 0 ; Altes et al, 1 9 9 1 ; Gradoni et
al, 1 9 9 3 ) .
MON-18
MOTS CLES : SIDA. Kala-azar. Zymodème MON-18, Portugal, L.donovani.
This Leishmania
strain was isolated from a b o n e marrow aspirate in Novy-MacNeal-Nicolle medium, a n d
was identified at the Laboratoire d'Écologie Médicale,
Montpellier, b y i s o e n z y m e electrophoresis using 15
e n z y m e s ( M o r e n o et a l . , 1 9 6 0 ; Rioux et al., 1 9 9 0 ) as
L. donovani
z y m o d e m e MON-18.
1
M H O M / F R / 7 8 / L E M 7 5 L. infantum
MON-1 and
MHOM/ET/67/HU 3 L. donovani
w e r e used as refere n ce strains.
This is the first time that L. donovani
ted in Portugal.
has b e e n isola-
Other strains o f L. donovani
MON-18 have b e e n isolated in Ethiopia a n d Sudan from both humans a n d
In t h e p r e s e n t n o t e , w e r e p o r t t h e isolation o f sandflies (Ashford et al, 1 9 9 2 ; El-Hassan et al, 1 9 9 3 ) .
G r a m i c c i a et al. in 1 9 8 2 h a v e f o u n d in Italy three
Leishmania
donovani
(MHOM/PT/92/IMT180) from a
strains o f L. donovani
MON-18 from two dogs a n d a
28-year old, drug addicted, Portuguese patient with
fox. T h e s e results have b e e n considered as u n e x p e c clinical visceral leishmaniasis (VL) and AIDS. H e w a s
ted b y M o r e n o et al. ( 1 9 8 6 ) .
b o r n in t h e Alto-Douro region, a well k n o w n e n d e mic area o f Portugal with the highest prevalence o f This isolation o f L. donovani
MON-18 in a Portuguese
VL ( A b r a n c h e s et al, 1 9 9 0 ) . W h e n a g e d f o u r h e
human c a s e o f VL is highly questionable. A possible
m o v e d to Lisbon, another e n d e m i c focus o f VL. T h e r e
explanation is that this VL c a s e w a s associated with a
is n o record h e ever had left Portugal.
m e c h a n i c a l l y transmitted infection a c q u i r e d b y t h e
* Disciplina de Protozoologia/Centro de Malária e outras Doenças
Tropicais (CMDT), Instituto de Higiene e Medicina Tropical
(IHMT), Rua da Junqueira 96, 1300 Lisboa. Portugal.
** Laboratoire d'Écologie Médicale et Pathologie Parasitaire, Faculté
de Médecine, 34000 Montpellier, France.
Correspondence : Dr. Lenea Campino, Disciplina de Protozoologia.
Instituto de Higiene e Medicina Tropical, Rua da Junqueira 96,
1300 Lisboa, Portugal, Fax : 351 1 3622458; Telef : 351 1 3622458.
Parasite, 1994, 1, 391-392
1. Aspartate aminotransferases 1 and 2 (E.C.2.6.1.1), glucose-phosphate isomerase (E.C.5.3 1.9). phosphoglucomutase (E.C.2.7.5.1),
glucose-6-phosphate
dehydrogenase
(E.C.1.1.1.49),
6Phosphogluconate dehydrogenase (E.C.I.1.1.44), malic enzyme
(E.C.1.1.1.40), malate dehydrogenase (E.C.1.1.1.47), isocitrate dehydrogenase (E.C.1.1.1.42), purine nucleoside phosphorilases 1 and 2
(E.C.3.2.2.1.), mannose-phosphate isomerase (E.C.5.3.1.8), fumarate hydratase (E.C.4.2.1.2), diaphorase (E.C.1.6.2.2) and glutamic
dehydrogenase (E.C.1.4.1.3).
Note d e recherche
391
CAMPING- L., SANTOS-GOMES G., PRATLONG F., DEDET J.P. and ABRANCHES P.
use o f a n e e d l e o r syringe shared b y drug addicted
partners as discussed b y Alvar et al. ( 1 9 9 4 ) .
PETERS
ACKNOWLEDGEMENTS
w
Leishmania.
Taxonomie et Phylogenese. Applications écoépidémiologiques.
Edited by J.-A. Rioux. Montpellier,
IMEEE, 1986, 105-117.
e thank Dr. Virgilio d o Rosario ( C M D T )
for a critical revision o f this paper.
B . S . , FISH D., GOLDEN
R., EVANS
D.A.,
BRYCESON
A.D.M. and PINCHING A.J. Visceral Leishmaniasis in HIV
Infection and AIDS : Clinical features and Response to
Therapy. Quarterly Journal
of Medicine,
New Series,
1990, 77, 1101-1111.
PIRES C A . , SANTOS-GOMES
G . M., PRATLONG
F . , RIBEIRO
H.,
CAMPINO L. and ABRANCHES P. Phlébotomes du Portugal.
REFERENCES
ABRANCHES P . , CONCF.IÇÂO-SILVA F . M . and SILVA-PEREIRA M . C D .
La leishmaniose viscérale dans la région de Lisbonne.
Identification enzymatique. Interprétation structurale du
foyer. In : Leishmania.
Taxonomie
et
Phylogenese.
Applications éco-épidémiologiques.
Edited by J . - A . Rioux.
Montpellier, IMEEE, 1986, 427-432.
ABRANCHES
AVELINO
P . , SAMPAIO-SILVA
M . L . , SANTOS-GOMES G . M . ,
I . C , PIRES C . A . , CONCF.IÇS'O-SILVA
IV. Infestation naturelle de Phlebotomus
ariasi par
Leishmania
infantum MON-24 dans le foyer de l'AltoDouro. Annales de Parasitologic
Humaine et Comparée,
1991, 66, 47-48.
Rioux J.-A., LANOTTE G . , SERRES E . , PRATLONG
F . , BASTEEN P.
and PERIERES J . T a x o n o m y o f L e i s h m a n i a . U s e o f
I s o e n z y m e s . Suggestions for a n e w classification.
Annales de Parasitologic
Humaine et Comparée, 1990,
65, 111-125.
F . M . , SEIXAS-
LOPES A . , SILVA-PEREIRA M . C D . and JANZ J . G . Kala-azar in
Accepté le 21 septembre 1994
Portugal. VIL Epidemiological survey in Alijô (endemic
region of Alto-Douro). V I I International Congress o f
Parasitology, Paris, August 1990 [abstract S6 E31.
ALTÉS J . , SALAS A . , RIERA M., UDINA M., GALMÉS A . , BALANZAT
J.,
BALLESTEROS A . , BUADES J . , SALVÂ F . and VILLALONGA C .
Visceral leishmaniasis : another HIV - associated opportunistic infection ? Report of eight cases and review of
the literature. AIDS, 1991, 5, 201-207.
ALVAR J . and JIMENEZ M. Could infected drug-users be potential Leishmania infantum reservoirs ? AIDS, 1994, 8, 854,
ASHEORD
R.W., SEAMAN J . , SCHORSCHER J . and PRATLONG F .
Epidemic Visceral leishmaniasis in Southern Sudan :
identity and systematic position of the parasites from
patients and vectors. Transactions of the Royal Society of
Tropical Medicine and Hygiene, 1992, 86, 379-380.
CAMPINO L . , SANTOS-GOMES G . M . , PRATLONG F . , D E D E T J . P . and
ABRANCHES P . HIV Leishmania
co-infection in Portugal ;
Isolation of Leishmania infantum MON 24. Transactions
of the Royal Society of Tropical Medicine and Hygiene,
1994, 88, 394.
EL-HASSAN A.M., HASHIM F.A., SIDDING ALI M., GHALIB H . W .
and ZIJLSTRA E . E . Kala-azar in western Upper Nile province in the southern Sudan and its spread to a nomadic
tribe from the north. Transactions of the Royal Society of
Tropical Medicine and Hygiene, 1993, 87, 395-398.
GRADOM
L . , SCALONE A. and GRAMICCIA M . H I V - L e i s h m a n i a
co-infections in Italy; serological data as an indication of
the s e q u e n c e o f acquisition o f the two infections.
Transactions
of the Royal Society of Tropical
Medicine
and Hygiene, 1993, 87, 94-96.
GRAMICCIA M . , MAAZOLN G . , RIOUX J.-A., LE BLANC S . , EVANS
D.A., PETERS W . , BETTINI
S . , GRADONI
L. and Pozio E.
Typage enzymatique d'un variant enzymatique chez le
Renard (Vulpes
vulpes)
et le Chien. Annales
de
Parasitologic Humaine et Comparée, 1982, 57, 527-531.
MORENO G . , RiouxJ.-A., LANOTTE G . , PRATLONG F . and SERRES
E.
392
Le c o m p l e x e
Leishmania
donovani
s.l. In :
Note de recherche
Parasite, 1 9 9 4 , 1, 3 9 1 - 3 9 2