HUMAN CYSTIC ECHINOCOCCOSIS: EVALUATION OF POST-TREATMENT SEROLOGIC FOLLOW-UP BY IgG SUBCLASS ANTIBODY DETECTION

STEPHEN D. LAWN Hospital for Tropical Diseases, London, United Kingdom; Cestode Zoonoses Research Group, School of Environment and Life Sciences, University of Salford, Salford, United Kingdom; Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom

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JOHN BLIGH Hospital for Tropical Diseases, London, United Kingdom; Cestode Zoonoses Research Group, School of Environment and Life Sciences, University of Salford, Salford, United Kingdom; Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom

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PHILIP S. CRAIG Hospital for Tropical Diseases, London, United Kingdom; Cestode Zoonoses Research Group, School of Environment and Life Sciences, University of Salford, Salford, United Kingdom; Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom

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PETER L. CHIODINI Hospital for Tropical Diseases, London, United Kingdom; Cestode Zoonoses Research Group, School of Environment and Life Sciences, University of Salford, Salford, United Kingdom; Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom

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Assessment of post-treatment disease activity among patients with cystic echinococcosis (CE) is insensitive using detection of CE-specific total IgG antibody. This study investigated whether serum concentrations of CE-specific IgG subclasses 1–4 correlate better with disease activity than total IgG. We studied a cohort of patients (n = 28) with symptomatic CE treated with anthelminthic drugs and surgery and who were followed up clinically and radiologically for a mean of 5.6 years (range = 3–12 years). Serial archived sera collected during follow-up were retrospectively analyzed by enzyme-linked immunosorbent assays using crude horse hydatid cyst fluid as antigen. Changes in concentrations of antibodies were correlated with clinical and radiologic outcome. At diagnosis, concentrations of CE-specific total IgG, IgG1, and IgG2 antibodies were significantly elevated in a greater proportion of patients compared with IgG3 and IgG4 antibodies. During post-treatment follow up, the IgG2 antibody response provided the best correlate of disease activity.

Author Notes

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