Biochemical and immunologic predictors of efficacy of treatment or reinfection risk for Schistosoma mansoni.
Most Schistosoma mansoni infections are egg-negative after a single dose of oxamniquine. A cohort of 661 infected children was treated at 6-month intervals and assessed for nutritional and parasitological status. Initial biochemical and immunologic markers were measured in a subset of 84 children. All were treated at the start of therapy and at 6 months. Immunoglobulins only served as markers for active infection. No markers were predictive of cure or reinfection, except initial infection intensity and serum low-density lipoprotein. Ten percent were persistently infected and had no change in infection intensity at any time-point. Several factors suggest that this group was biologically different. In addition to failing to reduce their worm burden, they had significantly higher initial intensity of infection (100 versus 65 eggs/g, P = 0.001) and significantly lower initial serum low-density lipoprotein (72 versus 104 mg/dL, P = 0.045). The biologic plausibility of this observation is discussed.
Reis
Eliana A G
EA
Oswaldo Cruz Foundation, Fiocruz, Salvador, Bahia, Brazil. ereis@cpqgm.fiocruz.br
Reis
Mitermayer G
MG
Silva
Rita De Cássia R
Rde C
Carmo
Theomira M A
TM
Assis
Ana Marlúcia O
AM
Barreto
Maurício L
ML
Parraga
Isabel M
IM
Santana
Mônica Leila P
ML
Blanton
Ronald E
RE
D000293:Adolescent; D000818:Animals; D002648:Child; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D012008:Recurrence; D012307:Risk Factors; D012550:Schistosoma mansoni / Q000276:immunology*; D012555:Schistosomiasis mansoni / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology*; D016896:Treatment Outcome