Neurocysticercosis: HP10 antigen detection is useful for the follow-up of the severe patients

• Published in: PLoS neglected tropical diseases Vol. 7; no. 3; p. e2096
• Main Authors: Fleury, Agnès, Garcia, Esperanza, Hernández, Marisela, Carrillo, Roger, Govezensky, Tzipe, Fragoso, Gladis, Sciutto, Edda, Harrison, Leslie J S, Parkhouse, R Michael Evans
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 01.03.2013; Public Library of Science (PLoS)
• Subjects: Accuracy; Adult; Aged; Antigens; Antigens, Helminth; Antigens, Helminth - analysis; Antigens, Helminth - blood; Antigens, Helminth - cerebrospinal fluid; Biological Markers; Biomarkers - analysis; Biomarkers - blood; Biomarkers - cerebrospinal fluid; Brain; Brain - diagnostic imaging; Cerebrospinal fluid; Clinical Laboratory Techniques; Clinical Laboratory Techniques - economics; Clinical Laboratory Techniques - methods; Cohort Studies; Confidence intervals; Cysticercosis; Diagnosis; Drug Monitoring; Drug Monitoring - economics; Drug Monitoring - methods; Enzyme-Linked Immunosorbent Assay; Enzyme-Linked Immunosorbent Assay - economics; Enzyme-Linked Immunosorbent Assay - methods; Evolution; Female; Humans; Life Sciences; Longitudinal Studies; Magnetic Resonance Imaging; Male; Medical imaging; Medicine; Methods; Middle Aged; Neurocysticercosis; Neurocysticercosis - diagnosis; Neurocysticercosis - drug therapy; NMR; Nuclear magnetic resonance; Parasites; Parasitic diseases; Parasitology; Parasitology - economics; Parasitology - methods; Patients; Properties; Prospective Studies; Radiography; Randomized Controlled Trials as Topic; Santé publique et épidémiologie; Studies; Substance abuse treatment; Mexico; Brain; Antigens, Helminth; Parasitology; Prospective Studies; Enzyme-Linked Immunosorbent Assay; Biological Markers; Clinical Laboratory Techniques; Humans; Middle Aged; Male; Neurocysticercosis; Randomized Controlled Trials as Topic; Magnetic Resonance Imaging; Adult; Female; Aged; Drug Monitoring; Longitudinal Studies; Cohort Studies
• ISSN: 1935-2735; 1935-2727; 1935-2735
• DOI: 10.1371/journal.pntd.0002096

The most severe clinical form of neurocysticercosis (NC) occurs when cysticerci are located in the subarachnoid space at the base of the brain (SaB). The diagnosis, monitoring and treatment of NC-SaB, constitutes a severe clinical challenge. Herein we evaluate the potential of the HP10 antigen detection enzyme-linked immunosorbent assay (HP10 Ag-ELISA) in the long term follow-up of NC-SaB cases. Assay performance was compared with that of Magnetic Resonance Imaging (MRI). In addition, the robustness of the HP10 Ag-ELISA was evaluated independently at two different institutions. A double-blind prospective cohort trial was conducted involving 38 NC-SaB cases and a total of 108 paired serum and cerebrospinal fluid (CSF) samples taken at intervals of 4 to 8 months for up to 43 months. At each medical visit, results of sera and CSF HP10 Ag-ELISA and MRI obtained at last visit were compared and their accuracy was evaluated retrospectively, considering radiological evolution between appointments. In the long-term follow-up study, HP10 Ag-ELISA had a better agreement than MRI with retrospective radiological evaluation. High reproducibility of HP10 Ag-ELISA between laboratories was also demonstrated. Results reported in this study establish for the first time the usefulness of the comparatively low cost HP10 Ag-ELISA for long term follow-up of NC-SaB patients.