Real-time PCR as a new tool for quantifying Leishmania infantum in liver in infected mice.

The parasitic loads of mouse livers experimentally infected with Leishmania infantum were determined using a double real-time quantitative PCR test targeted to the parasite DNA polymerase gene and to the mouse brain-derived neutrophic factor gene. The Leishmania DNA copy number was normalized to the number of mouse gene copies in order to quantify the former independently of liver weight. The correlation coefficient with the microtitration method was 0.66. This PCR assay can be considered for experimental pharmaceutical studies.

Immune recovery under highly active antiretroviral therapy is associated with restoration of lymphocyte proliferation and interferon-gamma production in the presence of Toxoplasma gondii antigens.

The in vitro lymphocyte proliferative response (LPR) and interferon (IFN)-gamma production in the presence of Toxoplasma antigen were evaluated in 97 human immunodeficiency virus (HIV)-1-infected patients with CD4 cell counts of <100 cells/microL (group 1), currently >300 cells/microL but previously <100 cells/microL (group 2), or always >300 cells/microL (group 3) and in 28 non-HIV-infected blood donors (group 4), all seropositive to Toxoplasma. In group 2, 81% of patients had a positive LPR, versus 20% in group 1 (P<10(-3)). IFN-gamma production was greater in group 2 than in group 1 (922 vs. 0 Deltapg/mL; P=10(-4)). Multivariate analysis found a significant association between a positive LPR to Toxoplasma antigen and a CD4 count >300 cells/microL (odds ratio [OR], 16.3; 95% confidence interval [CI], 5.3-50.2) and anti-Toxoplasma IgG titer >150 IU/mL (OR, 5; 95% CI, 1.6-15.2). Immune reconstitution under highly active antiretroviral therapy was associated with a restoration of immune responses against Toxoplasma.

[A study in the Ivory Coast (1985-1987) of the efficacy and tolerance of ivermectin (Mectizan) in human onchocerciasis. I. A comparative double-blind study of 220 patients with onchocerciasis treated with a single oral dose of 100, 150 or 200 mcg/kg]. / Etude en Côte-d'Ivoire (1985-1987) de l'efficacité et de la tolérance de l'ivermectine (Mectizan) dans l'onchocercose humaine. I. Etude comparative en double insu de 220 sujets onchocerquiens traités par dose unique orale de 100, 150 ou 200 mcg/kg.

Two hundred and twenty adult males living in endemic onchocerciasis areas in Ivory Coast, with a mean of 59 to 64 mf/mg of skin microfilariae, having or not ocular lesions, were divided into 4 homogeneous groups and treated by placebo or by a single oral dose of 100, 150 or 200 mcg/kg of ivermectin. Parasitological, clinical, ophthalmological, biological data were gathered before treatment (J less than 1) and at day 4 and 3, 6, 12 months post treatment. The doses of 150 to 200 mcg/kg gave the best results with a reduction of microfilariae of 75 to 79% at day 4 and of 97 to 99% at 3 months. A slight increase appears at six months reaching to 10% of the initial level, at 12 months. These posologies reduce also the number of ocular microfilariae 12 months after treatment. The percentage of patients presenting microfilariae in the cornea varies from 4 to 14% according to the given dose whereas it was initially between 26 and 33%, and in the anterior chamber from 22 to 16% instead of 62 to 67%. In patients who were still positive after treatment the detected number of ocular microfilariae was very small. Side effects starting 12 to 24 hours after treatment are similar to those appearing during the normal evolution of onchocerciasis. They were observed in 36% of subjects receiving a placebo and 56 to 65% of treated subjects. Statistically they are neither correlated with the intensity of parasitism nor to the given posology and disappear spontaneously few days later or after administration of aspirin and/or antihistaminic. Ivermectin given at a single oral dosage of 150 to 200 mcg/kg is a powerful microfilaricidal drug with a rapid and prolonged action and without major side effects.

[A study in the Ivory Coast (1985-1987) of the efficacy and tolerance of ivermectin (Mectizan) in human onchocerciasis. II. Evaluation in the light of mass campaigns on the effect of yearly or half-yearly administration of single oral doses of 100, 150 or 200 mcg/kg]. / Etude en Cote-d'Ivoire (1985-1987) de l'efficacité et de la tolérance de l'ivermectine (Mectizan) dans l'onchocercose humaine. II. Evaluation, en vue de campagnes de masse, des effets de l'administration annuelle ou semestrielle de doses uniques orales de 100, 150 ou 200 mcg/kg.

One hundred and twenty patients out of 220 in a previous study were retreated after 6 months or one year with doses of 100, 150 or 200 mcg/kg of ivermectin. The tolerance was excellent due probably to the small number of skin microfilariae obtained with the first treatment. The annual treatment with 150 to 200 mcg/kg, better than with 100 mcg/kg, keeps for the year following the second treatment the microfilariae number between 6 and 11% of the initial level. The half-yearly administration keeps it between 1 and 7% and especially 94 to 100% of these retreated patients have a level of microfilariae less than 5 mf/mg. The results obtained with the half-yearly treatment show a considerable reduction of the number of microfilariae in the anterior chamber of the eye and the percentage of positive patients. Ivermectin is a very efficient microfilaricidal drug for the treatment of onchocerciasis and the prevention of ocular complications. Its rational use in mass campaigns should reduce, if not interrupt, the transmission of this parasitic disease.

[A study in the Ivory Coast (1985-1987) of the efficacy and tolerance of ivermectin (Mectizan) in human onchocerciasis. III. The tolerance and efficacy of a single oral dose of 150 mcg/kg in children]. / Etude en Cote-d'Ivoire (1985-1987) de l'efficacité de la tolérance de l'ivermectine (Mectizan) dans l'onchocercose humaine. III. Tolérance et efficacité d'une dose unique orale de 150 mcg/kg chez les enfants.

One hundred and three male and female children of 6 to 14 years old with onchocerciasis, having or not ocular involvement and a mean skin microfilariae level of 36.1 mf/mg, received, in October 1986, a single oral dose of 150 mcg/kg ivermectin and controlled at day 4, 3 months, 6 months and 12 months post treatment. After the last control they were retreated with the same dose. The skin microfilariae count fell down to 94% of the initial level at day 4 and to 99% at 3 months. At 6 months the microfilariae count was 2% of the initial level and 5% at 12 months. The percentage of patients having microfilariae in the anterior chamber of the eye which was 33% before treatment fell down to 6% at 12 months. The percentage of patients having microfilariae in the cornea was 39% before treatment and 18% at 12 months. In the cornea and anterior chamber there was a very reduced number of microfilariae still present. 65% of the children had lesions of keratitis before treatment and 34% two months later. Adverse effects (fever, headache, pruritus, oedemas, myalgias, arthralgias) occurred in 64% of children after the first treatment and 50% after the second. They were of weak or moderate intensity and receded rapidly after administration of aspirin and/or anti-histaminic. The administration of ivermectin is an efficient and well tolerated drug in children above 5 years old.

[The placenta and malaria. A morphologic, parasitologic and clinical study (author's transl)]. / Placenta et paludisme. Etude morphologique, parasitologique et clinique.

In 115 consecutive placentae from an unselected population living in a high malaria endemic region (Franceville, Haut-Ogooué, Gabon, 40 (35%) have the peculiar lesions of maternal plasmodium infection. The lesions show considerable histological variation but the following features are constant: a) deposits of variable amounts of malarial pigment and b) excess of perivillous fibrinoid. Accumulation of maternal erythrocytes with parasites, concentration of macrophages in intervillous spaces and villities are inconstant. In addition, splitting and segmental thickening of the trophoblast basal membrane with occasional aggregations of dense fibrillary structures are found at ultrastructural level. 56% of the mothers have Plasmodium falciparum (94%) or Plasmodium malariae in their peripheral blood. Placental lesions have been found only in 65% of the cases with peripheral parasitemia. Although Plasmodium are present in 35 (87%) placentae, no parasites have been found in the cord blood. The difference between the mean birth-weight of full-term neonates from mothers with placental lesions (n = 38) or with normal placenta (n = 54) is 220 g. This difference is statistically highly significant (p less than 0,001). It appears that the low mean birth-weight is not related to the high percentage (39%) of primipare in the infected group but, in all probability, to the placental lesions.

[Toxoplasmosis and chronic myeloid leukemia]. / Toxoplasmose et leucémie myéloïde chronique

A patient suffering from chronic myeloid leukemia and used as a donor of leucocytes was found to have toxoplasmosis associated with a high level of IgG without an elevation of IgM which was maintained for several months. This case raises several points for discussion. Toxoplasmosis is a frequent complication of malignant hematological disease, it is often severe with neurological complications in more than half the patients affected. It is often difficult to diagnose. The parasite is arduous to isolate and serology is problematic to interpretate without reference to previous samples. This suggests it would be wise to measure the titre of anti-toxoplasma antibodies as part of the initial investigations of every malignant hemopathy and to repeat the measurements during the evolution of the disease. Any patient showing a high serological titre, even though it is stable and without IgM should be given systematically a specific treatment for toxoplasmosis, for as in the patient presented in this paper, such a serological picture is compatible with an increasing infection. The frequence of high serological titres seems to be greater among patients suffering from chronic myeloid leukemia than among another people. Then, transfusion of leucocytes of such patients may be the source of parasite transmission; this paper relates one case of post-transfusional toxoplasmosis.