Tripartite host-parasite-virus interactions reshape chronic visceral leishmaniasis through persistent Leptomonas seymouri co-infection

Background Visceral leishmaniasis (VL), caused by Leishmania donovani (LD), is increasingly associated with the insect-restricted trypanosomatid Leptomonas seymouri (LS), which harbours the RNA virus Leptomonas seymouri narna-like virus 1 (Lepsey NLV1). Our recent study demonstrated that LS co-infection with LD enhances survival of murine (RAW 264.7) and mammalian (THP-1) macrophages and augments LD and LS persistence compared to LD or LS mono-infection in vitro. However, the in vivo fate of LS and its viral endosymbiont during chronic VL remains poorly understood. This study investigated the long-term dynamics of parasite persistence, tissue dissemination and viral maintenance during experimental mono- and co-infection. Methods and Findings BALB/c mice were infected with LD, Lepsey NLV1-positive LS, virus-positive AG83 isolate, or LD: LS co-infections (2:1, 5:1 and 10:1) and monitored for up to seven months. Parasite burden, species composition and viral load were quantified using ITS1 qPCR, densitometry, nested RT-PCR and qRT-PCR, supported by microscopy and immunofluorescence assay. LS established productive visceral infection independently, with parasite burdens exceeding the infecting inoculum, indicating active in vivo replication. Co-infection, particularly at a 10:1 LD: LS ratio, promoted the greatest long-term parasite persistence in visceral organs. Temporal analysis revealed early predominance of LS followed by progressive recovery of LD during chronic infection. Lepsey NLV1 was detected in visceral organs and blood for at least up to five months. Morphological analyses demonstrated intracellular LS amastigote-like forms in murine macrophages and transformation of splenic parasites into promastigotes, confirming parasite viability within mammalian tissues. Conclusions These findings demonstrate sustained visceral persistence of Lepsey NLV1-positive LS in mice and identify dynamic host-parasite-virus interactions that reshape infection during chronic co-infection. This work challenges the conventional view of VL as a strictly mono-parasitic disease and highlights a previously underappreciated tripartite interaction with potential implications of LS and its virus endosymbiont for VL pathogenesis.