Is real-time PCR more useful than a conventional PCR for the clinical management of leishmaniasis?

It is currently unknown if the use of a real-time polymerase chain reaction (PCR) adds value to the diagnosis and follow-up prognosis of patients affected by leishmaniasis. We performed a study using a real-time PCR directedagainst the α-polymerase gene and a semiquantitative PCR that target the SSU ribosomal RNA (rRNA) gene as controlfor the diagnosis and quantification of parasites in patients with visceral (VL) and cutaneous (CL) leishmaniasis. Oursingle copy real-time PCR missed one diagnosis of VL compared with the conventional PCR, whereas both PCR methodswere able to detect Leishmania parasites in CL. Under anti-leishmania treatment the kinetics of parasitemia were comparable with the two methods. The real-time PCR directed against α-polymerase of Leishmania despite being able to makea more accurate quantification of parasites does not add to the decision-making management compared with a semiquantitative PCR, and it is comparatively expensive.