title: Comparison of flow cytometry and indirect immunofluorescence assay in the diagnosis and cure criterion after therapy of American tegumentary leishmaniasis by anti-live Leishmania (Viannia) braziliensis immunoglobulin G.
abstract: The aim of this study was to compare the techniques of indirect immunofluorescence assay (IFA) and flow cytometry to clinical and laboratorial evaluation of patients before and after clinical cure and to evaluate the applicability of flow cytometry in post-therapeutic monitoring of patients with American tegumentary leishmaniasis (ATL). Sera from 14 patients before treatment (BT), 13 patients 1 year after treatment (AT), 10 patients 2 and 5 years AT were evaluated. The results from flow cytometry were expressed as levels of IgG reactivity, based on the percentage of positive fluorescent parasites (PPFP). The 1:256 sample dilution allowed us to differentiate individuals BT and AT. Comparative analysis of IFA and flow cytometry by ROC (receiver operating characteristic curve) showed, respectively, AUC (area under curve)=0.8 (95% CI=0.64-0.89) and AUC=0.90 (95% CI=0.75-0.95), demonstrating that the flow cytometry had equivalent accuracy. Our data demonstrated that 20% was the best cut-off point identified by the ROC curve for the flow cytometry assay. This test showed a sensitivity of 86% and specificity of 77% while the IFA had a sensitivity of 78% and specificity of 85%. The after-treatment screening, through comparative analysis of the technique performance indexes, 1, 2 and 5 years AT, showed an equal performance of the flow cytometry compared with the IFA. However, flow cytometry shows to be a better diagnostic alternative when applied to the study of ATL in the cure criterion. The information obtained in this work opens perspectives to monitor cure after treatment of ATL.
authors.affiliation: Centro de Pesquisas Aggeu Magalhães, FIOCRUZ, Recife, Pernambuco, Brazil. andresadeolinda@gmail.com
authors.forename: Andresa Pereira
authors.initials: AP
authors.lastname: de Oliveira
authors.forename: Maria Carolina Accioly Brelaz
authors.initials: MC
authors.lastname: de Castro
authors.forename: Amanda Ferreira
authors.initials: AF
authors.lastname: de Almeida
authors.forename: Marina de Assis
authors.initials: Mde A
authors.lastname: Souza
authors.forename: Beatriz Coutinho
authors.initials: BC
authors.lastname: de Oliveira
authors.forename: Luiza Campos
authors.initials: LC
authors.lastname: Reis
authors.forename: Hiro
authors.initials: H
authors.lastname: Goto
authors.forename: Maria Edileuza Felinto
authors.initials: ME
authors.lastname: de Brito
authors.forename: Beatriz Julieta
authors.initials: BJ
authors.lastname: Celeste
authors.forename: Olindo Assis
authors.initials: OA
authors.lastname: Martins-Filho
authors.forename: Valéria Rêgo Alves
authors.initials: VR
authors.lastname: Pereira
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000913:Antibodies, Protozoan / Q000097:blood / Q000276:immunology; D005260:Female; D005434:Flow Cytometry / Q000379:methods*; D019084:Fluorescent Antibody Technique, Indirect / Q000379:methods*; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology* / Q000627:therapeutic use; D007892:Leishmania braziliensis / Q000276:immunology*; D016773:Leishmaniasis, Cutaneous / Q000097:blood / Q000188:drug therapy / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods; D015203:Reproducibility of Results; D013997:Time Factors; D055815:Young Adult
chemical_list: D000913:Antibodies, Protozoan; D007074:Immunoglobulin G