Serological rebound in congenital toxoplasmosis: long-term follow-up of 133 children

Wallon, Martine; Cozon, G.; Écochard, René; Lewin, Patricia; Peyron, François

doi:10.1007/s004310100805

Cited by 63 publications

(38 citation statements)

References 9 publications

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“…4, IgG titers paralleled IFN-␥ levels. This antibody profile (i.e., transitory negation followed by rebound) is commonly observed for treated patients (14,24). The impact of treatment in reducing the IFN-␥-specific response in tuberculosis has been described previously (1,9,15) and suggests that such tests could be used for monitoring patient response to treatment (1).…”

Section: Discussionmentioning

confidence: 74%

Diagnosis of Congenital Toxoplasmosis by Using a Whole-Blood Gamma Interferon Release Assay

et al. 2010

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Congenital toxoplasmosis in newborns is generally subclinical, but infected infants are at risk of developing ocular lesions. Diagnosis at birth relies mainly on serological tests. Cell-mediated immunity plays the major role in resistance to infection but is not routinely investigated for diagnostic purposes. Here, we describe a simple test based on the gamma interferon (IFN-␥) response after stimulation of whole blood by crude parasitic antigens. One milliliter of heparinized blood was centrifuged; plasma was kept for routine serological tests, and pellets were resuspended in culture medium. After 24 h of culture in the presence of crude Toxoplasma gondii antigen, the cells were centrifuged and the supernatant was assayed for IFN-␥. For 62 infants under 1 year of age born to mothers who were infected during pregnancy, the sensitivity and specificity of the test were 94% (with positive results for 16 of 17 infected infants) and 98% (with negative results for 44 of 45 uninfected infants), respectively. The false-negative result was for a treated baby who gave positive results after the withdrawal of treatment. The false positive was obtained for a 3-month-old baby. For a cohort of 124 congenitally infected patients between 1 and 30 years of age, the sensitivity of the assay was 100%. We present a simple test based on IFN-␥ secretion to assess cell-mediated immunity in toxoplasmosis. As only 1 ml of blood is required to investigate humoral and cellular immunity, our assay is well adapted for the study of congenital toxoplasmosis in infants. Using purified antigens or recombinant peptides may improve the test performance.

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Section: Discussionmentioning

confidence: 74%

Diagnosis of Congenital Toxoplasmosis by Using a Whole-Blood Gamma Interferon Release Assay

et al. 2010

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“…Only IgE is commonly related to bad clinical prognosis, and IgG4 could have either negative or no influence. 7,22,100,101 The few studies on the role of anti-T. gondii antibodies on congenital infections indicate that fetuses or newborns who produce specific IgG2, IgG4 or IgE have bad clinical prognosis. 7,22,100,101…”

Section: Igs and Fcrs Polymorphismsmentioning

confidence: 99%

Congenital toxoplasmosis: candidate host immune genes relevant for vertical transmission and pathogenesis

et al. 2010

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“…Our study revealed 22 congenitally infected infants with IgG seronegativity in the Liaison (Table 1) and seropositivity in the Sabin-Feldman dye test. Furthermore, in subsequent samples the infants were seropositive, but this was not a serological rebound but rather a lack of sensitivity (3,35). In particular, a diminished sensitivity of the Liaison IgG was observed between 6 and 12 months of life due to the decrease of maternally diaplacental antibodies against Toxoplasma gondii.…”

Section: Discussionmentioning

confidence: 91%

Evaluation of the Liaison Automated Testing System for Diagnosis of Congenital Toxoplasmosis

Prusa

Hayde

Pollak

et al. 2012

Clin. Vaccine Immunol.

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Congenital toxoplasmosis is a worldwide health problem, and different screening strategies exist. Testing of toxoplasma-specific antibodies in infants identifies congenital toxoplasmosis during the first year of life. However, experience with commercial available immunoassays is limited. The aim of this study was to evaluate both the performance and analytical characteristics of the Liaison diagnostic system in infants. In a retrospective study, serum Toxoplasma gondii antibodies were measured in samples from 333 infants, including 212 noninfected infants and 121 infants with congenital toxoplasmosis. A total of 1,157 umbilical cord blood and peripheral serum samples were analyzed. Liaison toxoplasma-specific IgG and IgM antibodies and the IgG avidity index were compared to the infection status of the infant, determined by the Sabin-Feldman dye test and immunosorbent agglutination assay-IgM. All noninfected infants were seronegative by Liaison IgG within the first year of life. The Liaison system showed a sensitivity of 81.8%, a specificity of 100.0%, a positive predictive value of 100.0%, a negative predictive value of 90.6%, and overall agreement of 84.4% by comparison with the dye test. Overall agreement of both IgM test systems was 96.0%. In this study cohort, avidity did not show a potential diagnostic benefit for the detection of congenital infection. In conclusion, the Liaison system is a valuable tool to monitor the serologic course of infants at risk. A final serologic confirmatory test is recommended to improve the rate of detection of congenital toxoplasmosis at 1 year of life. Protocols of routine follow-up testing in infants and accurate diagnostic tools after acute gestational infections are needed to improve medical care.

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Serological rebound in congenital toxoplasmosis: long-term follow-up of 133 children

Abstract: serological rebound is common in children with congenital toxoplasmosis but, due to the risk and constraints, an additional course of treatment and more ophthalmological surveillance than currently practiced do not seem warranted.

Cited by 63 publications

References 9 publications

Diagnosis of Congenital Toxoplasmosis by Using a Whole-Blood Gamma Interferon Release Assay

Diagnosis of Congenital Toxoplasmosis by Using a Whole-Blood Gamma Interferon Release Assay

Congenital toxoplasmosis: candidate host immune genes relevant for vertical transmission and pathogenesis

Evaluation of the Liaison Automated Testing System for Diagnosis of Congenital Toxoplasmosis

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