The diagnostic accuracy of serologic and molecular methods for detecting visceral leishmaniasis in HIV infected patients: meta - analysis

Detalhes bibliográficos
Autor(a) principal: Cota, Gláucia Fernandes
Data de Publicação: 2012
Outros Autores: Sousa, Marcos Roberto de, Demarqui, Fábio Nogueira, Rabello, Ana Lúcia Teles
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da FIOCRUZ (ARCA)
Texto Completo: https://www.arca.fiocruz.br/handle/icict/7424
Resumo: Fundação Oswaldo Cruz. Centro de Pesquisas René Rachou. Laboratory of Clinical Research. Belo Horizonte, MG, Brazil/Fundação Hospitalar do Estado de Minas Gerais. Hospital Eduardo de Menezes. Belo Horizonte, MG, Brazil
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spelling Cota, Gláucia FernandesSousa, Marcos Roberto deDemarqui, Fábio NogueiraRabello, Ana Lúcia Teles2014-03-19T17:01:57Z2014-03-19T17:01:57Z2012COTA, Gláucia Fernandes et al. The diagnostic accuracy of serologic and molecular methods for detecting visceral leishmaniasis in HIV infected patients: meta - analysis. Plos Neglected Tropical Diseases. 2012, vol.6, pp. e16651935-2735https://www.arca.fiocruz.br/handle/icict/7424engPublic Library of ScienceThe diagnostic accuracy of serologic and molecular methods for detecting visceral leishmaniasis in HIV infected patients: meta - analysisinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleFundação Oswaldo Cruz. Centro de Pesquisas René Rachou. Laboratory of Clinical Research. Belo Horizonte, MG, Brazil/Fundação Hospitalar do Estado de Minas Gerais. Hospital Eduardo de Menezes. Belo Horizonte, MG, BrazilUniversidade Federal de Minas Gerais. Post-Graduate Program in Adult Health Sciences. Belo Horizonte, MG, BrazilUniversidade Federal de Minas Gerais. Exact Sciences Institute. Statistic Department. Belo Horizonte, MG, BrazilFundação Oswaldo Cruz. Centro de Pesquisas René Rachou. Laboratory of Clinical Research. Belo Horizonte, MG, BrazilBACKGROUND: Human visceral leishmaniasis (VL), a potentially fatal disease, has emerged as an important opportunistic condition in HIV infected patients. In immunocompromised patients, serological investigation is considered not an accurate diagnostic method for VL diagnosis and molecular techniques seem especially promising. OBJECTIVE: This work is a comprehensive systematic review and meta-analysis to evaluate the accuracy of serologic and molecular tests for VL diagnosis specifically in HIV-infected patients. METHODS: Two independent reviewers searched PubMed and LILACS databases. The quality of studies was assessed by QUADAS score. Sensitivity and specificity were pooled separately and compared with overall accuracy measures: diagnostic odds ratio (DOR) and symmetric summary receiver operating characteristic (sROC). RESULTS: Thirty three studies recruiting 1,489 patients were included. The following tests were evaluated: Immunofluorescence Antibody Test (IFAT), Enzyme linked immunosorbent assay (ELISA), immunoblotting (Blot), direct agglutination test (DAT) and polimerase chain reaction (PCR) in whole blood and bone marrow. Most studies were carried out in Europe. Serological tests varied widely in performance, but with overall limited sensitivity. IFAT had poor sensitivity ranging from 11% to 82%. DOR (95% confidence interval) was higher for DAT 36.01 (9.95-130.29) and Blot 27.51 (9.27-81.66) than for IFAT 7.43 (3.08-1791) and ELISA 3.06 (0.71-13.10). PCR in whole blood had the highest DOR: 400.35 (58.47-2741.42). The accuracy of PCR based on Q-point was 0.95; 95%CI 0.92-0.97, which means good overall performance. CONCLUSION: Based mainly on evidence gained by infection with Leishmania infantum chagasi, serological tests should not be used to rule out a diagnosis of VL among the HIV-infected, but a positive test at even low titers has diagnostic value when combined with the clinical case definition. Considering the available evidence, tests based on DNA detection are highly sensitive and may contribute to a diagnostic workup.LeishmaniasisVisceral/diagnosisMolecular Diagnostic Techniques/methodsParasitology/methodsSensitivity and SpecificitySerologic Tests/methodsinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZORIGINALThe diagnostic accuracy of serologic and molecular methods for detecting visceral leishmaniasis in HIV infected patients.pdfThe diagnostic accuracy of serologic and molecular methods for detecting visceral leishmaniasis in HIV infected patients.pdfapplication/pdf2959896https://www.arca.fiocruz.br/bitstream/icict/7424/1/The%20diagnostic%20accuracy%20of%20serologic%20and%20molecular%20methods%20for%20detecting%20visceral%20leishmaniasis%20in%20HIV%20infected%20patients.pdff1ad8971de334019c8f7c404dadd4946MD51LICENSElicense.txtlicense.txttext/plain; charset=utf-81914https://www.arca.fiocruz.br/bitstream/icict/7424/2/license.txt7d48279ffeed55da8dfe2f8e81f3b81fMD52TEXTThe diagnostic accuracy of serologic and molecular methods for detecting visceral leishmaniasis in HIV infected patients.pdf.txtThe diagnostic accuracy of serologic and molecular methods for detecting visceral leishmaniasis in HIV infected patients.pdf.txtExtracted texttext/plain11https://www.arca.fiocruz.br/bitstream/icict/7424/5/The%20diagnostic%20accuracy%20of%20serologic%20and%20molecular%20methods%20for%20detecting%20visceral%20leishmaniasis%20in%20HIV%20infected%20patients.pdf.txtb308b7fe5c1c2bbdc0cb686d451b84aaMD55THUMBNAILThe diagnostic accuracy of serologic and molecular methods for detecting visceral leishmaniasis in HIV infected patients.pdf.jpgThe diagnostic accuracy of serologic and molecular methods for detecting visceral leishmaniasis in HIV infected patients.pdf.jpgGenerated Thumbnailimage/jpeg2159https://www.arca.fiocruz.br/bitstream/icict/7424/4/The%20diagnostic%20accuracy%20of%20serologic%20and%20molecular%20methods%20for%20detecting%20visceral%20leishmaniasis%20in%20HIV%20infected%20patients.pdf.jpg11c79ee2503636b7457fc500f9cb1cdeMD54icict/74242018-04-05 23:45:29.666oai:www.arca.fiocruz.br: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ório InstitucionalPUBhttps://www.arca.fiocruz.br/oai/requestrepositorio.arca@fiocruz.bropendoar:21352018-04-06T02:45:29Repositório Institucional da FIOCRUZ (ARCA) - Fundação Oswaldo Cruz (FIOCRUZ)false
dc.title.pt_BR.fl_str_mv The diagnostic accuracy of serologic and molecular methods for detecting visceral leishmaniasis in HIV infected patients: meta - analysis
title The diagnostic accuracy of serologic and molecular methods for detecting visceral leishmaniasis in HIV infected patients: meta - analysis
spellingShingle The diagnostic accuracy of serologic and molecular methods for detecting visceral leishmaniasis in HIV infected patients: meta - analysis
Cota, Gláucia Fernandes
Leishmaniasis
Visceral/diagnosis
Molecular Diagnostic Techniques/methods
Parasitology/methods
Sensitivity and Specificity
Serologic Tests/methods
title_short The diagnostic accuracy of serologic and molecular methods for detecting visceral leishmaniasis in HIV infected patients: meta - analysis
title_full The diagnostic accuracy of serologic and molecular methods for detecting visceral leishmaniasis in HIV infected patients: meta - analysis
title_fullStr The diagnostic accuracy of serologic and molecular methods for detecting visceral leishmaniasis in HIV infected patients: meta - analysis
title_full_unstemmed The diagnostic accuracy of serologic and molecular methods for detecting visceral leishmaniasis in HIV infected patients: meta - analysis
title_sort The diagnostic accuracy of serologic and molecular methods for detecting visceral leishmaniasis in HIV infected patients: meta - analysis
author Cota, Gláucia Fernandes
author_facet Cota, Gláucia Fernandes
Sousa, Marcos Roberto de
Demarqui, Fábio Nogueira
Rabello, Ana Lúcia Teles
author_role author
author2 Sousa, Marcos Roberto de
Demarqui, Fábio Nogueira
Rabello, Ana Lúcia Teles
author2_role author
author
author
dc.contributor.author.fl_str_mv Cota, Gláucia Fernandes
Sousa, Marcos Roberto de
Demarqui, Fábio Nogueira
Rabello, Ana Lúcia Teles
dc.subject.en.pt_BR.fl_str_mv Leishmaniasis
Visceral/diagnosis
Molecular Diagnostic Techniques/methods
Parasitology/methods
Sensitivity and Specificity
Serologic Tests/methods
topic Leishmaniasis
Visceral/diagnosis
Molecular Diagnostic Techniques/methods
Parasitology/methods
Sensitivity and Specificity
Serologic Tests/methods
description Fundação Oswaldo Cruz. Centro de Pesquisas René Rachou. Laboratory of Clinical Research. Belo Horizonte, MG, Brazil/Fundação Hospitalar do Estado de Minas Gerais. Hospital Eduardo de Menezes. Belo Horizonte, MG, Brazil
publishDate 2012
dc.date.issued.fl_str_mv 2012
dc.date.accessioned.fl_str_mv 2014-03-19T17:01:57Z
dc.date.available.fl_str_mv 2014-03-19T17:01:57Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.citation.fl_str_mv COTA, Gláucia Fernandes et al. The diagnostic accuracy of serologic and molecular methods for detecting visceral leishmaniasis in HIV infected patients: meta - analysis. Plos Neglected Tropical Diseases. 2012, vol.6, pp. e1665
dc.identifier.uri.fl_str_mv https://www.arca.fiocruz.br/handle/icict/7424
dc.identifier.issn.none.fl_str_mv 1935-2735
identifier_str_mv COTA, Gláucia Fernandes et al. The diagnostic accuracy of serologic and molecular methods for detecting visceral leishmaniasis in HIV infected patients: meta - analysis. Plos Neglected Tropical Diseases. 2012, vol.6, pp. e1665
1935-2735
url https://www.arca.fiocruz.br/handle/icict/7424
dc.language.iso.fl_str_mv eng
language eng
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Public Library of Science
publisher.none.fl_str_mv Public Library of Science
dc.source.none.fl_str_mv reponame:Repositório Institucional da FIOCRUZ (ARCA)
instname:Fundação Oswaldo Cruz (FIOCRUZ)
instacron:FIOCRUZ
instname_str Fundação Oswaldo Cruz (FIOCRUZ)
instacron_str FIOCRUZ
institution FIOCRUZ
reponame_str Repositório Institucional da FIOCRUZ (ARCA)
collection Repositório Institucional da FIOCRUZ (ARCA)
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