Serosurvey and risk factors of acute Leishmania donovani infection among febrile HIV infected indivduals in Abuja: A hospital-based cross-sectional study

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, 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, from 7th April to 10th October 2015. EDTA anticoagulated blood was tested for CD4 + cell counts, while sera were tested for anti-L. donovani IgM antibodies using flow cytometry and Enzyme Linked Immunosorbent Assay (ELISA), respectively. Interviwer-based questionnaires were used to collect participants’ sociodemographic variables. Data were analysed for statistical association and relation between seropositivity of L. donovani IgM and risk factors using MedCalc software version 16.8.4. Results: Of the 340 participants studied, the seroprevalence of anti-L.donovani IgM was 8.2%. The mean CD4 + cell count of those with L. donovani IgM seropositivity (n = 28) was 119.4 cells/mm3. There was statistical relation between CD4 + cell counts and L. donovani IgM seropositivity. There was statistical association between L. donovani IgM seropositivity with age of participants (p = 0.014), residential area (p = 0.033), living condition (p = 0.0001) and occupation of participants (p = 0.06). However, there was no statistical association of L. donovani IgM seropositivity with gender, income status and educational level of participants (p > 0.05). Conclusion: Findings from this study revealed that L. donovani is an etiological agent of acute fever in HIV infected patients and significantly associated with CD4 + lymphopaenia in co-infected patients. It's recommended that L. donovani screening be considered during differential diagnosis of HIV patients with prolong fever.