FGF21 levels are increased in HIV-1-infected patients, especially in those with lipodystrophy, and this increase is closely associated with insulin resistance, metabolic syndrome and makers of liver damage. Further research will be required to determine whether the increase in FGF21 levels is caused by a compensatory response or resistance to FGF21, and to establish the potential of FGF21 as a biomarker of altered metabolism in HIV-1-infected, antiretroviral-treated patients.
Background
Multiplex molecular panels are relentlessly replacing conventional methods for the detection of enteric pathogens from stool samples in clinical and research laboratories. Here we evaluated four commercial multiplex real-time PCR assays for the detection of
Cryptosporidium hominis
/
parvum
,
Giardia duodenalis
and
Entamoeba histolytica
.
Methods
The diagnostic performance of the Gastroenteritis/Parasite Panel I (Diagenode), the RIDAGENE Parasitic Stool Panel (R-Biopharm), the Allplex Gastrointestinal Parasite Panel 4 (Seegene) and the FTD Stool Parasites (Fast Track) real-time PCR methods was assessed against a reference panel of 126 well-characterized DNA samples including
Cryptosporidium hominis
(
n
= 29),
Cryptosporidium parvum
(
n
= 3),
Giardia duodenalis
(
n
= 47),
Entamoeba histolytica
(
n
= 3), other parasite species (
n
= 20), and apparently healthy subjects (
n
= 24).
Principal findings
Obtained diagnostic sensitivities ranged from 53–88% for
Cryptosporidium hominis/parvum
, and from 68–100% for G.
duodenalis
. The R-Biopharm method achieved the best performance for the detection of
Cryptosporidium hominis/parvum
both in terms of diagnostic sensitivity (87.5%) and detection limit (a 100-fold increase compared to other tests). The Fast Track method was particularly suited for the detection of
G
.
duodenalis
, achieving a 100% sensitivity and a detection limit at least 10-fold superior. Detection of
E
.
histolytica
was similarly achieved by all compared methods except Diagenode.
Conclusions
Diagnostic performance varied largely depending on the method used and the targeted pathogen species. Factors including test sensitivity/specificity, cost, patient population surveyed, laboratory workflow, and diagnostic algorithm should be carefully considered when choosing the most appropriate multiplex PCR platform.
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