Urine Antigen Detection for the Diagnosis of Human Neurocysticercosis

Yesenia Castillo Department of Microbiology, Universidad Peruana Cayetano Heredia, Lima, Peru; Cysticercosis Unit, Instituto de Ciencias Neurológicas, Lima, Perú; Instituto Peruano de Parasitología Clínica y Experimental, Lima, Perú; Prince Leopold Institute of Tropical Medicine, Antwerp, Belgium; School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Perú; Centro Internacional de Zoonosis, Universidad Central del Ecuador, Quito, Ecuador; Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland

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Silvia Rodriguez Department of Microbiology, Universidad Peruana Cayetano Heredia, Lima, Peru; Cysticercosis Unit, Instituto de Ciencias Neurológicas, Lima, Perú; Instituto Peruano de Parasitología Clínica y Experimental, Lima, Perú; Prince Leopold Institute of Tropical Medicine, Antwerp, Belgium; School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Perú; Centro Internacional de Zoonosis, Universidad Central del Ecuador, Quito, Ecuador; Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland

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Hector H. García Department of Microbiology, Universidad Peruana Cayetano Heredia, Lima, Peru; Cysticercosis Unit, Instituto de Ciencias Neurológicas, Lima, Perú; Instituto Peruano de Parasitología Clínica y Experimental, Lima, Perú; Prince Leopold Institute of Tropical Medicine, Antwerp, Belgium; School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Perú; Centro Internacional de Zoonosis, Universidad Central del Ecuador, Quito, Ecuador; Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland

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Jef Brandt Department of Microbiology, Universidad Peruana Cayetano Heredia, Lima, Peru; Cysticercosis Unit, Instituto de Ciencias Neurológicas, Lima, Perú; Instituto Peruano de Parasitología Clínica y Experimental, Lima, Perú; Prince Leopold Institute of Tropical Medicine, Antwerp, Belgium; School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Perú; Centro Internacional de Zoonosis, Universidad Central del Ecuador, Quito, Ecuador; Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland

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Anke Van Hul Department of Microbiology, Universidad Peruana Cayetano Heredia, Lima, Peru; Cysticercosis Unit, Instituto de Ciencias Neurológicas, Lima, Perú; Instituto Peruano de Parasitología Clínica y Experimental, Lima, Perú; Prince Leopold Institute of Tropical Medicine, Antwerp, Belgium; School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Perú; Centro Internacional de Zoonosis, Universidad Central del Ecuador, Quito, Ecuador; Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland

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Maria Silva Department of Microbiology, Universidad Peruana Cayetano Heredia, Lima, Peru; Cysticercosis Unit, Instituto de Ciencias Neurológicas, Lima, Perú; Instituto Peruano de Parasitología Clínica y Experimental, Lima, Perú; Prince Leopold Institute of Tropical Medicine, Antwerp, Belgium; School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Perú; Centro Internacional de Zoonosis, Universidad Central del Ecuador, Quito, Ecuador; Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland

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Richar Rodriguez-Hidalgo Department of Microbiology, Universidad Peruana Cayetano Heredia, Lima, Peru; Cysticercosis Unit, Instituto de Ciencias Neurológicas, Lima, Perú; Instituto Peruano de Parasitología Clínica y Experimental, Lima, Perú; Prince Leopold Institute of Tropical Medicine, Antwerp, Belgium; School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Perú; Centro Internacional de Zoonosis, Universidad Central del Ecuador, Quito, Ecuador; Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland

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Mylagritos Portocarrero Department of Microbiology, Universidad Peruana Cayetano Heredia, Lima, Peru; Cysticercosis Unit, Instituto de Ciencias Neurológicas, Lima, Perú; Instituto Peruano de Parasitología Clínica y Experimental, Lima, Perú; Prince Leopold Institute of Tropical Medicine, Antwerp, Belgium; School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Perú; Centro Internacional de Zoonosis, Universidad Central del Ecuador, Quito, Ecuador; Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland

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D. Paolo Melendez Department of Microbiology, Universidad Peruana Cayetano Heredia, Lima, Peru; Cysticercosis Unit, Instituto de Ciencias Neurológicas, Lima, Perú; Instituto Peruano de Parasitología Clínica y Experimental, Lima, Perú; Prince Leopold Institute of Tropical Medicine, Antwerp, Belgium; School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Perú; Centro Internacional de Zoonosis, Universidad Central del Ecuador, Quito, Ecuador; Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland

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Armando E. Gonzalez Department of Microbiology, Universidad Peruana Cayetano Heredia, Lima, Peru; Cysticercosis Unit, Instituto de Ciencias Neurológicas, Lima, Perú; Instituto Peruano de Parasitología Clínica y Experimental, Lima, Perú; Prince Leopold Institute of Tropical Medicine, Antwerp, Belgium; School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Perú; Centro Internacional de Zoonosis, Universidad Central del Ecuador, Quito, Ecuador; Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland

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Robert H. Gilman Department of Microbiology, Universidad Peruana Cayetano Heredia, Lima, Peru; Cysticercosis Unit, Instituto de Ciencias Neurológicas, Lima, Perú; Instituto Peruano de Parasitología Clínica y Experimental, Lima, Perú; Prince Leopold Institute of Tropical Medicine, Antwerp, Belgium; School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Perú; Centro Internacional de Zoonosis, Universidad Central del Ecuador, Quito, Ecuador; Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland

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Pierre Dorny Department of Microbiology, Universidad Peruana Cayetano Heredia, Lima, Peru; Cysticercosis Unit, Instituto de Ciencias Neurológicas, Lima, Perú; Instituto Peruano de Parasitología Clínica y Experimental, Lima, Perú; Prince Leopold Institute of Tropical Medicine, Antwerp, Belgium; School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Perú; Centro Internacional de Zoonosis, Universidad Central del Ecuador, Quito, Ecuador; Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland

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Neurocysticercosis (NCC) is a major cause of seizures and epilepsy. Diagnosis is based on brain imaging, supported by immunodiagnosis in serum or cerebrospinal fluid (CSF). Lumbar puncture is invasive and painful. Blood sampling is slightly painful and poorly accepted. Urine antigen detection has been used for other parasites and tried in NCC with suboptimal performance. We used a monoclonal antibody-based ELISA to detect Taenia solium antigens in urine from 87 Peruvian neurocysticercosis patients (viable cysts, N = 34; subarachnoid cysticercosis, N = 10; degenerating parasites, N = 7; calcified lesions, N = 36) and 32 volunteers from a non-endemic area of Peru. Overall sensitivity of urine antigen detection for viable parasites was 92%, which decreased to 62.5% in patients with a single cyst. Most patients (30/36, 83%) with only calcified cysticercosis were urine antigen negative. Antigen levels in paired serum/urine samples (evaluated in 19 patients) were strongly correlated. Non-invasive urine testing for T. solium antigens provides a useful alternative for NCC diagnosis.

Author Notes

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