Immune complexes as a tool for strongyloidiasis immunodiagnosis in kidney and liver transplant candidate

Corral, Marcelo Andreetta; Gonçalves, Ana Lúcia Ribeiro; Costa, Idessânia Nazareth; Abdala, Edson; Pierrotti, Lı́gia Camera; Chieffi, Pedro Paulo; Costa-Cruz, Júlia Maria; Gryschek, Ronaldo César Borges; Paula, Fabiana Martins de

doi:10.1111/pim.12920

Cited by 1 publication

(1 citation statement)

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“…Screening for asymptomatic infection before planned immunosuppression should also not only rely on serology, but include direct methods, possibly molecular tests, or empirical treatment with ivermectin, as suggested by some guidelines [ 38 , 39 ]. Future alternatives include next-generation serological tests based on recombinant antigens or the detection of immune complexes, which might cause false-negative IgG results in chronic infection [ 13 , 40 ]. Coproantigen detection or nucleic acid amplification might also overcome some of the above mentioned obstacles [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Serological diagnosis of strongyloidiasis: An evaluation of three commercial assays

Weitzel,

Dittrich,

Mockenhaupt

et al. 2024

PLoS Negl Trop Dis

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Background Strongyloidiasis is caused by a neglected nematode, manifesting as chronic intestinal infection with potentially severe manifestations. The disease is an emerging problem in non-endemic countries affecting travelers and migrants. Diagnosis of strongyloidiasis is hampered by the lack of standardization and absence of a gold standard. Since adequate direct methods to detect the motile larvae in stool samples are not widely available, other techniques such as serology have been developed. Methods We evaluated three commercial ELISA kits (DRG Instruments, IVD Research, and Bordier Affinity Products) to detect IgG antibodies against Strongyloides stercoralis assays utilizing serum samples from travelers with microscopically confirmed strongyloidiasis (n = 50) and other imported helminthic infections (n = 159) as well as healthy controls (n = 50). Results The DRG, IVD, and Bordier assays showed sensitivities of 58.0%, 64.0%, and 56.0%, respectively. Specificity values were 96.0%, 96.0%, and 92.0% in healthy controls, and 67.3%, 62.9%, and 76.7% in cases with other helminth infections, respectively. Cross-reactions were mostly observed in cases with other nematodes (37.5%, 42.5%, and 20.0%, respectively), but also in trematode (33.3%, 38.1%, and 19.0%, respectively) and in cestode infections (25.0%, 30.0%, and 32.5%, respectively). Conclusion The study demonstrates the diagnostic limitations of serological assays to detect or exclude cases of strongyloidiasis in returning travelers, who frequently present with recent or acute infections.

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