The prevalence of Leishmania RNA virus in cutaneous leishmaniasis: a meta-analysis and systematic review.
BACKGROUND: While numerous studies have investigated the role and presence of RNA viruses within Leishmania parasites, the existing literature presents a fragmented view of Leishmania RNA virus (LRV) prevalence in parasites associated with cutaneous leishmaniasis (CL). Therefore, the present study aimed to elucidate the prevalence of LRV in parasites obtained from patients with CL.
METHODS: To achieve this aim, we conducted a systematic literature search across international databases, specifically Web of Science, PubMed, Embase, and Scopus. We extracted relevant studies reporting the prevalence of LRV in parasites obtained from patients with CL, utilizing predefined keywords and covering the period from December 1988 to August 2024. The extracted data underwent meta-analysis using a random-effects model, with statistical analyses performed in STATA version 14.
RESULTS: Our search yielded 44 studies that fulfilled the eligibility criteria, representing a total sample size of 2,276 participants. LRV detection was performed on biopsied lesion fragments and cultured isolates derived from these lesions. Among the 2,276 CL patients, 647 tested positive for LRV. We observed regional variations in LRV prevalence, with 45.16% in the New World (NW) and 30.00% in the Old World (OW). The majority of included studies examined Leishmania (Viannia) guyanensis, L. (V.) braziliensis, L. (Leishmania) major, and Leishmania (L.) tropica. LRV prevalence was 32.26% in lesion biopsies and 30.96% in cultured isolates. Notably, LRV exhibited a high prevalence in Leishmania species obtained from mucocutaneous leishmaniasis (MCL), suggesting a strong association between LRV1 and this clinical manifestation in the NW.
CONCLUSION: This study demonstrated a substantial prevalence of LRV in CL. LRV was identified in both lesion biopsies and cultured isolates, revealing significant regional variations with higher prevalence in the NW compared to the OW. Furthermore, a strong association was observed between LRV1 and MCL in the NW.