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首页> 外文期刊>Clinical and diagnostic laboratory immunology >Predicting Kala-Azar Disease Manifestations in Asymptomatic Patients with Latent Leishmania donovani Infection by Detection of Antibody against Recombinant K39 Antigen
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Predicting Kala-Azar Disease Manifestations in Asymptomatic Patients with Latent Leishmania donovani Infection by Detection of Antibody against Recombinant K39 Antigen

机译：通过检测针对重组K39抗原的抗体预测无症状潜伏利什曼原虫感染的无症状患者的Kala-Azar疾病表现

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Clinically visceral leishmaniasis is suspected in only a fraction of infected persons, as the majority of these may not have clinical manifestations and remain asymptomatic. There is scanty information on diagnosing latent infections and predicting disease in asymptomatic persons. We therefore carried out a study on asymptomatic contacts of patients with visceral leishmaniasis and post-kala-azar dermal leishmaniasis by using methods for detection of antibody to recombinant K39 (rK39) antigen. A total of 240 patients with leishmaniasis and 150 asymptomatic contacts were tested for anti-rK39 immunoglobulin G (IgG) and IgA antibodies. Fifty-five asymptomatic persons were found to be seropositive. These individuals were monitored every 3 months for 1 year. On follow-up, 43.9% of the asymptomatic seropositive contacts developed kala-azar within the first 3 months, and a cumulative total of 69% developed kala-azar within 1 year. The rest remained asymptomatic and self-healed the infection. The sensitivity and specificity of rK39 enzyme-linked immunosorbent assay (ELISA) and dipstick tests were 100%, while an in-house-developed latex agglutination test had 80% sensitivity. The antibody profile showed that the IgG anti-rK39 antibodies reached a titer of up to 10?6 within 6 months of infection, started declining thereafter, and completely disappeared in 2 to 3 years in successfully treated cases. Significant titers of IgA antibodies were detectable a little earlier than those of IgG antibodies and were undetectable after 6 months. The study showed that mass screening of family members and contacts by using anti-rK39 ELISA could be a highly reliable tool for early diagnosis and to plan prophylactic treatment of latently infected asymptomatic carriers to eradicate kala-azar.
机译：临床内脏利什曼病仅在一部分感染者中被怀疑，因为这些人中的大多数可能没有临床表现并且没有症状。在无症状患者中诊断潜在感染和预测疾病的信息很少。因此，我们通过使用针对重组K39（rK39）抗原的抗体检测方法，对内脏利什曼病和黑热病后皮肤利什曼病患者的无症状接触进行了研究。总共对240名利什曼病患者和150名无症状接触者进行了抗rK39免疫球蛋白G（IgG）和IgA抗体测试。发现有55名无症状者为血清反应阳性。每3个月对这些人进行一次监测，持续1年。随访时，无症状的血清反应阳性接触者中有43.9％在头3个月内患上了黑热病，而在1年内累积总数中有69％出现了黑热病。其余患者无症状，可自愈。 rK39酶联免疫吸附测定（ELISA）和量油尺测试的灵敏度和特异性为100％，而内部开发的乳胶凝集测试的灵敏度和特异性为80％。抗体谱显示，IgG抗rK39抗体在感染后6个月内达到最高10 6 的效价，此后开始下降，并在成功治疗的病例中在2至3年内完全消失。 IgA抗体的显着效价比IgG抗体的效价稍早被检测到，并且在6个月后无法检测到。研究表明，使用抗rK39 ELISA大规模筛查家庭成员和联系者可能是一种高度可靠的工具，可用于早期诊断和计划对潜伏感染的无症状携带者进行根除黑热病的预防性治疗。

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