Case Report: In Situ and Systemic Immune Response to Mucosal Leishmaniasis in an HIV-Infected Patient

Author:

Amato Valdir Sabbaga12,Franco Lucas Augusto Moyses1,de Souza Regina Maia1,Maia da Silva Camila Alves1,Ramundo Mariana Severo1,Côrtes Marina Farrel3,Corrêa-Castro Gabriela45,Santos-Oliveira Joanna Reis45,Da-Cruz Alda M.4,Pagliari Carla6,Galo Luciane Kanashiro6,Tuon Felipe Francisco7

Affiliation:

1. Universidade de São Paulo, Faculdade de Medicina, Instituto de Medicina Tropical, Laboratório de Parasitologia, São Paulo, Brazil;

2. Universidade de São Paulo, Faculdade de Medicina, Departamento de Doenças e Moléstias Infecciosas, São Paulo, Brazil;

3. Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo, Laboratório de Bacteriologia e Resistência Antimicrobiana, São Paulo, Brazil;

4. Laboratório Interdisciplinar de Pesquisas Médicas, Instituto Oswaldo Cruz, Fundacao Oswaldo Cruz, Rio de Janeiro, Brazil;

5. Núcleo de Ciências Biomédicas Aplicadas, Instituto Federal de Educação, Ciência e Tecnologia – IFRJ, Rio de Janeiro, Brazil;

6. Departamento de Patologia, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil;

7. Pontifícia Universidade Católica do Paraná, Laboratório de Doenças Infecciosas e Emergentes, Curitiba, Brazil

Abstract

In situ and systemic evaluations of the immune responses of HIV-infected patients to mucosal leishmaniasis have been poorly described. We describe a recently diagnosed HIV-infected patient with mucosal leishmaniasis who was characterized by a CD4 count of 85 cells/mm3 and nasal septum destruction resulting from pruritic and ulcerated nasal mucosa with crust formation and progression over 2 years. In situ and systemic immune evaluations of T cell activation, memory, and exhaustion were conducted using cytofluorometric assays, and sequencing of the Leishmania species was performed. The immune profile of HIV-infected patient with mucosal leishmaniasis shows a mixed Th1/Th2 pattern and an activated and exhausted status.

Publisher

American Society of Tropical Medicine and Hygiene

Subject

Virology,Infectious Diseases,Parasitology

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