Follow-up of surgically treated patients with cystic echinococcosis: can novel recombinant antigens compete with imaging? Analysis of a patient cohort.

Stojkovic, Marija; Adt, Hans-Micha; Rosenberger, Kerstin; Boubaker, Ghalia; Hernandez-Gonzalez, Ana; Junghanss, Thomas; Zwahlen, Marcel; Siles-Lucas, Mar (2017). Follow-up of surgically treated patients with cystic echinococcosis: can novel recombinant antigens compete with imaging? Analysis of a patient cohort. Tropical medicine and international health TM&IH, 22(5), pp. 614-621. Blackwell Science 10.1111/tmi.12859

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OBJECTIVE To compare the performance of two novel recombinant antigens (EgP29, 2B2t) with imaging in a well-defined cohort of surgically treated cystic echinococcosis (CE) patients to determine whether serology reflects surgical cure as defined by imaging. METHODS From a cohort of 223 CE-confirmed patients of a national clinical center for echinococcosis, 36 surgically treated patients were eligible for analysis. Sera were tested by enzyme-linked immunosorbent assay (ELISA) for specific IgG and IgG4 antibodies against the EgP29 and 2B2t antigens. We used a hierarchical linear regression model to examine the course of antibody levels over time for each patient. A meta-analysis of the patient-specific estimates of the time to negativity was performed using the metan command in Stata. RESULTS The range of positive serological results at the beginning of post-surgical monitoring was 34-60%: 2B2t 51%, 2B2t-IgG4 34%, EgP29 60% and EgP29-IgG4 40%. The pooled estimates of time to seronegativity were as follows: 2B2t-ELISA 3.92 (3.24, 4.61) years; 2B2t-IgG4-ELISA 4.60 (3.91, 5.29) years; EgP29-ELISA 3.94 (3.50, 4.39) years; EgP29-IgG4-ELISA 2.55 (1.93, 3.18) years. CONCLUSION After surgical treatment, antibodies to the recombinant antigens 2B2t and EgP29 become negative in the majority of CE-confirmed, surgically cured patients. The major drawback is the fact that only around half of the CE-confirmed, surgically treated patients were at all responsive to the test antigens, so they are of limited benefit for documenting primary cure. Equally, these antigens do not appear to be sensitive to recurrences.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine
05 Veterinary Medicine > Department of Infectious Diseases and Pathobiology (DIP) > Institute of Parasitology

UniBE Contributor:

Boubaker, Ghalia and Zwahlen, Marcel

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services
600 Technology > 630 Agriculture

ISSN:

1360-2276

Publisher:

Blackwell Science

Language:

English

Submitter:

Doris Kopp Heim

Date Deposited:

04 May 2017 10:13

Last Modified:

11 Sep 2017 19:04

Publisher DOI:

10.1111/tmi.12859

PubMed ID:

28218991

Uncontrolled Keywords:

cystic echinococcosis equinococosis quística follow-up hidatidosis hydatid disease maladie hydatique seguimiento serology serología suivi sérologie échinococcose kystique

BORIS DOI:

10.7892/boris.99639

URI:

https://boris.unibe.ch/id/eprint/99639

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