Comparative Analysis of the Diagnostic Performance of Six Major Echinococcus granulosus Antigens Assessed in a Double-Blind, Randomized Multicenter Study

LORENZO C; FERREIRA H. B.; MONTEIRO K. M.; ROSENZVIT M. C.; KAMENETZKY L.; GARCIA H. H.; VASQUEZ Y.; NAQUIRA C.; SANCHEZ E.; LORCA M.; CONTRERAS M.; LAST J.; GONZALEZ-SAPIENZA G. G.

JOURNAL OF CLINICAL MICROBIOLOGY

American Society for Microbiology

Lugar: Estados Unidos; Año: 2005 vol. 43 p. 2764 - 2770

0095-1137

The serodiagnosis of hydatid disease is a valuable instrument for clinical diagnosis and epidemiologicalsurveillance of high-risk populations. In the past decade a wealth of reports on the diagnostic performance ofnumerous antigens have been produced. However, their diagnostic value has been estimated under differentconditions, using different serum collection, therefore precluding their direct comparison. Here we report anunbiased comparison of the same batch of six major E. granulosus antigens, namely, hydatid cyst fluid (HCF),native antigen B (AgB), two recombinant AgB subunits, an AgB-derived synthetic peptide, and recombinantcytosolic malate dehydrogenase from E. granulosus (EgMDH), against the same serum collection. The doubleblindanalysis was performed using a standardized protocol and receiver operating characteristic (ROC) dataanalysis by a network of six South American laboratories. High intercenter reproducibility was attained, andthe intralaboratory analysis allowed the comparative ranking of the antigen panel. HCF, AgB, and its AgB8/1subunit exhibited equivalent diagnostic efficiencies, 81.4% ± 0.5%, 81.3% ± 0.6%, and 81.9% ± 2.0%, respectively;with a more favorable balance toward specificity in the case of the last antigen. The diagnosticefficiencies for the other three antigens were 76.8% ± 6.8%, 69.1% ± 2.7%, and 66.8% ± 2.1%, for the peptide,the AgB8/2 subunit, and the EgMDH, respectively. The study also included an analysis of batch-to-batchvariation in the diagnostic performance of different HCF regional preparations. Based on these results, asuggested recommendation on the use of these antigens was drawn.