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Abstract：
Visceral leishmaniasis (VL) occurs due to the evolution, virulence, and adaptation of Leishmania, vector biology, host immune system evasion, and reservoir hosts. Parasitemia can be involved as a warning regarding the clinical severity of VL The present study aims to evaluate the relationship between parasitemia and the prognosis of individuals with VL. Blood and bone marrow samples from individuals with VL were analyzed to identify parasite and quantify or measure parasite burden. Individuals were classified in the clinical score model of risk of death by disease proposed by Coura-Vital et al. (PLoS Negl Trop Dis 8(12): e33742014, 2014). 39/74 individuals presented a better prognosis, and 35/74 individuals presented a worse prognosis. HIV + VL co-infection was present in 32 individuals, of which 12 were considered severe. The group aged 51 to 64 was classified as severe, with a decrease in leukocytes (p-value 0.0295) and neutrophils (p-value 0.0476). L. infantum DNA was identified in blood and bone marrow, in 69 individuals, and not detected in 5 individuals. The quantification of the parasite showed greater parasitemia in bone marrow (P = 0.0003) with an average of 4.70 × 104 Leishmanias/mL about blood, with 0.29 × 104 Leishmanias/mL. Individuals in the age group aged 51 to 64 co-infected with HIV + VL had higher parasitemia (p-value 0.0150) with 2.44 × 104 Leishmanias/mL in blood and bone marrow than in the group aged 20 to 50. Parasitemia, measured by molecular biology in blood and bone marrow, was related to the worst clinical prognosis of VL in the age group aged 51 to 64.
摘要：
内脏利什曼病（VL）的发生是由于进化，毒力,和对利什曼原虫的适应，载体生物学,宿主免疫系统逃避，和水库主机。寄生虫血症可以作为有关VL临床严重程度的警告。本研究旨在评估寄生虫血症与VL患者预后之间的关系。分析来自具有VL的个体的血液和骨髓样品以鉴定寄生虫并定量或测量寄生虫负荷。在Coura-Vital等人提出的疾病死亡风险临床评分模型中对个体进行分类。(PLoSNeglTropDis8(12):e33742014,2014)。39/74个体预后较好，和35/74个体呈现较差的预后。HIV+VL共感染存在于32个人中，其中12人被认为是严重的。51至64岁的人群被归类为严重人群，白细胞（p值0.0295）和中性粒细胞（p值0.0476）减少。在血液和骨髓中鉴定了婴儿L.在69个人中，在5个人中没有检测到。寄生虫的定量显示骨髓中更大的寄生虫血症（P=0.0003），血液中平均为4.70×104利什曼虫/mL，0.29×104利什曼尼亚/mL。同时感染HIVVL的51至64岁年龄组的个体在血液和骨髓中的寄生虫血症较高（p值0.0150），为2.44×104利什曼虫/mL。寄生虫血症,通过血液和骨髓中的分子生物学测量，在51～64岁年龄组中，VL的临床预后最差。
