Viscerotropic leishmaniasis in Iran: Current insights and future directions

Abstract

Background: Viscerotropic leishmaniasis (VTL), a recently recognized variant of visceral leishmaniasis (VL), presents unique clinical challenges due to its nonspecific symptoms, primarily caused by Leishmania tropica. VTL is increasingly prevalent in cutaneous leishmaniasis (CL) endemic regions, particularly in Iran. This study reviews the distribution and identification of VTL in human and animal hosts in Iran, examining host demographics, geographic location, causative Leishmania species, clinical manifestations, and genetic diversity to enhance understanding of leishmaniasis epidemiology.

Methods: A comprehensive database search identified 23 relevant studies utilizing PCR techniques for species identification.

Results: Findings indicate that VTL in Iran is predominantly caused by L. tropica, with occasional cases attributed to L. major. Interestingly, L. infantum, typically associated with VL, has also been implicated in CL across various regions, suggesting its potential role in dermotropic leishmaniasis (DL) in humans. Additionally, rare cases of L. tropica-induced VTL in dogs have been reported.

Conclusion: Addressing VTL requires a multidisciplinary approach that integrates research, surveillance, and targeted interventions to improve diagnosis, treatment, and prevention. Furthermore, developing rapid, cost-effective diagnostic tools to distinguish VTL from other infections and evaluating therapies for VTL caused by L. tropica and L. major are crucial steps in protecting vulnerable populations and reducing the disease burden.