Diagnosing human asymptomatic visceral leishmaniasis in an urban area of the State of Minas Gerais, using serological and molecular biology techniques

Moreno, Elizabeth Castro; Melo, Maria Norma; Lambertucci, José Roberto; Serufo, José Carlos; Andrade, Antero Silva Ribeiro de; Antunes, Carlos Maurício Fabricio; Genaro, Odair; Carneiro, Mariângela

doi:10.1590/s0037-86822006000500001

Cited by 41 publications

(41 citation statements)

References 33 publications

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“…A lower quantity of antibodies in these subjects with asymptomatic infection may explain the lighter impression on the immunochromatographic strip. This observation was also made by Moreno and others, 25 who established, for the diagnosis of asymptomatic infection by TRALd, that the test result should interpreted by three observers. The authors found wide disagreement between assessments and low reproducibility of the results (κ = 0.14).…”

Section: Discussionsupporting

confidence: 52%

“…The authors found wide disagreement between assessments and low reproducibility of the results (κ = 0.14). 25 This bias might explain the low agreement between the TRALd and ELISArK39 results, because both tests use the same antigen. In the present study, we observed the best κ agreement between the results of tests that use similar antigens.…”

Section: Discussionmentioning

confidence: 99%

“…4,13,25 The comparison of tests may provide some additional information that contributes to the selection of the serological tests that best discriminates between infected and uninfected subjects. In this respect, ELISA assays, which are easily performed compared with IIFT and MST, would be an interesting option for this diagnosis.…”

Section: Discussionmentioning

confidence: 99%

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Antileishmania Immunological Tests for Asymptomatic Subjects Living in a Visceral Leishmaniasis-Endemic Area in Brazil

Silva

Romero²,

Nascentes³

et al. 2011

The American Society of Tropical Medicine and Hygiene

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Abstract. The objective of this study was to evaluate the behavior of different tests used for the diagnosis of visceral leishmaniasis (VL) in asymptomatic subjects living in an endemic area. No gold standard is available for the diagnosis of asymptomatic infection with Leishmania . In continuation of a previous study, 1,017 subjects living in a VL-endemic area were clinically reevaluated. Of these, 576 had at least one positive serological test in a first assessment. About 3 years after the first evaluation, none of the subjects had progressed to clinical VL. Among this group, 246 subjects were selected, and five serological tests (enzyme-linked immunosorbent assay p [ELISAp], ELISArK39, ELISArK26, indirect immunofluorescence test [IIFT] using L. amazonensis promastigote antigen, and an immunochromatographic test using rK39 antigen [TRALd]) and the Montenegro skin test (MST) were repeated. There was a significant increase in the number of subjects who tested positive in the MST, IIFT, ELISAp, and ELISArK39 in the second evaluation. For all tests, there were subjects who tested positive in the first evaluation and negative in the second evaluation. A positive result in the serological tests and MST in subjects from the endemic area studied did not indicate a risk of progression to VL and may only be temporary.

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Section: Discussionsupporting

confidence: 52%

Section: Discussionmentioning

confidence: 99%

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Antileishmania Immunological Tests for Asymptomatic Subjects Living in a Visceral Leishmaniasis-Endemic Area in Brazil

Silva

Romero²,

Nascentes³

et al. 2011

The American Society of Tropical Medicine and Hygiene

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“…In addition, sensitivity of these methods decreases because of low antibody levels in bloods of asymptomatic patients. 6,11,12 One of the most sensitive and specific methods in the diagnosis of VL is polymerase chain reaction (PCR). For diagnosing patients with clinical symptoms, PCR has 90% and greater sensitivity, 13 whereas microscopic methods and blood culture have 70.5% and 74.5% sensitivity, respectively.…”

Section: Introductionmentioning

confidence: 99%

Utility of the Microculture Method in Non-Invasive Samples Obtained from an Experimental Murine Model with Asymptomatic Leishmaniasis

Allahverdiyev

Bağırova²,

Çakır-Koç³

et al. 2012

The American Society of Tropical Medicine and Hygiene

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Abstract. The sensitivity of diagnostic methods for visceral leishmaniasis (VL) decreases because of the low number of parasites and antibody amounts in asymptomatic healthy donors who are not suitable for invasive sample acquisition procedures. Therefore, new studies are urgently needed to improve the sensitivity and specificity of the diagnostic approaches in non-invasive samples. In this study, the sensitivity of the microculture method (MCM) was compared with polymerase chain reaction (PCR), enzyme-linked immunosorbent assay (ELISA), and immunofluorescent antibody test (IFAT) methods in an experimental murine model with asymptomatic leishmaniasis. Results showed that the percent of positive samples in ELISA, IFAT, and peripheral blood (PB) -PCR tests were 17.64%, 8.82%, and 5.88%, respectively, whereas 100% positive results were obtained with MCM and MCM-PCR methods. Thus, this study, for the first time, showed that MCM is more sensitive, specific, and economic than other methods, and the sensitivity of PCR that was performed to samples obtained from MCM was higher than sensitivity of the PCR method sampled by PB.

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“…However, this technique also detected positive results for subjects living in areas of endemicity but who did not progress to classic disease. In addition, there was frequent disagreement between the results of serological tests and PCR (12)(13)(14)(15)(16).…”

mentioning

confidence: 99%

Anti-Leishmania infantum IgG Antibody Avidity in Visceral Leishmaniasis

Tibúrcio

Anversa

Kanunfre

et al. 2013

Clin Vaccine Immunol

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bIgG avidity tests are used to discriminate acute from chronic infections. There are few reports on the IgG avidity profile of patients with visceral leishmaniasis (VL). This study investigated the anti-Leishmania IgG avidity in patients with classic VL (n ‫؍‬ 10), patients showing clinical cure after treatment (n ‫؍‬ 18), and asymptomatic subjects with at least one positive Leishmania test (n ‫؍‬ 20). All subjects were from areas in Brazil where VL is endemic. Serum samples were collected from each subject on two different occasions. IgG avidity was evaluated by Western blotting. The proportion of high-avidity antibodies was higher in all samples from patients with classic VL. In contrast, low-avidity antibodies predominated in subjects with a history of VL, including 13 cases (72.2%) in the first assessment and 14 (77.8%) in the second. Fifteen (75%) of the asymptomatic subjects presented a predominance of low-avidity antibodies in the first assessment, and the frequency of high-avidity antibodies increased over time in seven subjects (35%) of this group. Antibodies against the 14-and/or 16-kDa antigen fraction were detected in the first assessment in all patients with classic VL, in 10 (55.5%) treated patients, and in 10 (50%) asymptomatic subjects. These were highavidity antibodies in most cases. In the asymptomatic group, an increase in IgG avidity against the 14-and/or 16-kDa antigen fraction was observed in three cases (15%). The results indicate distinct responses in infected and asymptomatic subjects, probably associated with the length of time after infection. In this respect, IgG avidity tests represent a new approach to better characterize asymptomatic VL.

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Diagnosing human asymptomatic visceral leishmaniasis in an urban area of the State of Minas Gerais, using serological and molecular biology techniques

Cited by 41 publications

References 33 publications

Antileishmania Immunological Tests for Asymptomatic Subjects Living in a Visceral Leishmaniasis-Endemic Area in Brazil

Antileishmania Immunological Tests for Asymptomatic Subjects Living in a Visceral Leishmaniasis-Endemic Area in Brazil

Utility of the Microculture Method in Non-Invasive Samples Obtained from an Experimental Murine Model with Asymptomatic Leishmaniasis

Anti-Leishmania infantum IgG Antibody Avidity in Visceral Leishmaniasis

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