Immunologic tests in patients after clinical cure of visceral leishmaniasis.
The results of five serologic tests (ELISA using promastigote antigen [ELISAp] and recombinant K39 [ELISArK39] and K26 [ELISArK26] antigens, indirect immunofluorescence test using promastigote antigen [IIFT], and immunochromatographic tests using the rK39 antigen [TRALd]) and of the Montenegro skin test (MST) were analyzed in 41 individuals treated for kala-azar and living in Porteirinha, Minas Gerais, Brazil. The tests were carried out 1 week to 12 years after specific treatment. All MSTs during the 8 months after treatment were negative, whereas after 1 year, 28 (84.8%) were positive. Negativity in all serologic tests was observed for 11 (26.8%) of the 41 individuals, whereas positivity in at least one test was observed for 70.3% of subjects evaluated > or = 2 years after treatment. With respect to each exam, positivity was 38.0% for TRALd, 61.9% for ELISA rK39, 47.6% for ELISA rK26, 38.0% for ELISAp, and 40.5% for IIFT. None of the individuals presented recurrence of the disease during the 4 years of follow-up. The tests were repeated in 24 of the 41 individuals, after some time, and the results were the same in 33.3% of the cases. We conclude that serological tests for kala-azar might continue to be positive after treatment of the disease, although this does not indicate a poor prognosis or a poor therapeutic response.
De Almeida Silva
Luciana
L
Department of Tropical Medicine and Infectology, Federal University of Triângulo Mineiro, Uberaba, Brazil.
Romero
Héctor Dardo
HD
Prata
Aluízio
A
Costa
Roberto Teodoro
RT
Nascimento
Evaldo
E
Carvalho
Sílvio Fernandes Guimarães
SF
Rodrigues
Virmondes
V
D000293:Adolescent; D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D000818:Animals; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D002845:Chromatography / Q000379:methods; D004285:Dogs; D004359:Drug Therapy, Combination; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect / Q000379:methods; D006801:Humans; D007159:Immunologic Tests / Q000379:methods*; D007223:Infant; D007898:Leishmaniasis, Visceral / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D008536:Meglumine / Q000627:therapeutic use; D000077485:Meglumine Antimoniate; D008875:Middle Aged; D009942:Organometallic Compounds / Q000627:therapeutic use; D012008:Recurrence; D012882:Skin Tests / Q000379:methods; D013997:Time Factors
D000981:Antiprotozoal Agents; D009942:Organometallic Compounds; D008536:Meglumine; D000077485:Meglumine Antimoniate; D000666:Amphotericin B