Abstract Leishmania braziliensis is the most prevalent agent causing cutaneous leishmaniasis (CL) in Brazil. While inflammation is a hallmark of CL, few parasites are found at the lesion site, leading to challenges regarding diagnosis. Using L. braziliensis kDNA and human 18S rRNA as targets, the present study developed a qPCR assay to determine parasite load in biopsies from CL patients residing in an endemic area in northeastern Brazil. In addition, we investigated whether parasite load correlated with clinical outcome and observed that patients with higher parasite load were more likely to fail therapy. Moreover, CL patients in the early phase of infection presented higher levels of parasite transcripts than individuals in later phases. Thus, our results suggest that parasite load as determined by qPCR may constitute a valuable prognostic tool to aid in both the determination of disease severity and treatment outcome.
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