Imperial College London
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DrIngridMuller

Faculty of Medicine, Department of Infectious Disease

Visiting Reader
 
 
 
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i.muller

 
 
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Location

 

120Wright Fleming WingSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Franssen:2021:10.1128/mBio.00971-21,
author = {Franssen, SU and Takele, Y and Adem, E and Sanders, MJ and Müller, I and Kropf, P and Cotton, JA},
doi = {10.1128/mBio.00971-21},
journal = {mBio},
pages = {1--19},
title = {Diversity and within-host evolution of Leishmania donovani from visceral Leishmaniasis patients with and without HIV coinfection in northern Ethiopia.},
url = {http://dx.doi.org/10.1128/mBio.00971-21},
volume = {12},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Visceral leishmaniasis (VL) is a fatal disease and a growing public health problem in East Africa, where Ethiopia has one of the highest VL burdens. The largest focus of VL in Ethiopia is driven by high prevalence in migrant agricultural workers and associated with a high rate of coinfection with HIV. This coinfection makes VL more difficult to treat successfully and is associated with a high rate of relapse, with VL/HIV patients frequently experiencing many relapses of VL before succumbing to this infection. We present genome-wide data on Leishmania donovani isolates from a longitudinal study of cohorts of VL and VL/HIV patients reporting to a single clinic in Ethiopia. Extensive clinical data allow us to investigate the influence of coinfection and relapse on the populations of parasites infecting these patients. We find that the same parasite population is responsible for both VL and VL/HIV infections and that, in most cases, disease relapse is caused by recrudescence of the population of parasites that caused primary VL. Complex, multiclonal infections are present in both primary and relapse cases, but the infrapopulation of parasites within a patient loses genetic diversity between primary disease presentation and subsequent relapses, presumably due to a population bottleneck induced by treatment. These data suggest that VL/HIV relapses are not caused by genetically distinct parasite infections or by reinfection. Treatment of VL does not lead to sterile cure, and in VL/HIV, the infecting parasites are able to reestablish after clinically successful treatment, leading to repeated relapse of VL. IMPORTANCE Visceral leishmaniasis (VL) is the second largest cause of deaths due to parasite infections and a growing problem in East Africa. In Ethiopia, it is particularly associated with migrant workers moving from regions of nonendemicity for seasonal agricultural work and is frequently found as a coinfection with HIV, which leads to frequent VL relapse following trea
AU  - Franssen,SU
AU  - Takele,Y
AU  - Adem,E
AU  - Sanders,MJ
AU  - Müller,I
AU  - Kropf,P
AU  - Cotton,JA
DO  - 10.1128/mBio.00971-21
EP  - 19
PY  - 2021///
SN  - 2150-7511
SP  - 1
TI  - Diversity and within-host evolution of Leishmania donovani from visceral Leishmaniasis patients with and without HIV coinfection in northern Ethiopia.
T2  - mBio
UR  - http://dx.doi.org/10.1128/mBio.00971-21
UR  - https://www.ncbi.nlm.nih.gov/pubmed/34182785
UR  - https://journals.asm.org/doi/10.1128/mBio.00971-21
UR  - http://hdl.handle.net/10044/1/90346
VL  - 12
ER  -
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