Comparative analysis of the diagnostic performance of six major Echinococcus granulosus antigens assessed in a double-blind randomized multi-center study

LORENZO, C.; FERREIRA, H.; MONTEIRO, K.; MARA CECILIA ROSENZVIT; KAMENETZKY, L.; GARCÍA, H.; VASQUEZ, Y.; NAQUIRA, C.; SÁNCHEZ, E.; GONZÁLEZ-SAPIENZA, G.

JOURNAL OF CLINICAL MICROBIOLOGY

American Society for Microbiology.

Año: 2005 vol. 43 p. 2764 - 2770

0095-1137

The serodiagnosis of hydatid disease is a valuable instrument for clinicaldiagnosis and epidemiological surveillance of high-risk populations. In the pastdecade a wealth of reports on the diagnostic performance of numerous antigenshave been produced. However, their diagnostic value has been estimated underdifferent conditions, using different serum collection, therefore precludingtheir direct comparison. Here we report an unbiased comparison of the same batchof six major E. granulosus antigens, namely, hydatid cyst fluid (HCF), nativeantigen B (AgB), two recombinant AgB subunits, an AgB-derived synthetic peptide,and recombinant cytosolic malate dehydrogenase from E. granulosus (EgMDH),against the same serum collection. The double-blind analysis was performed usinga standardized protocol and receiver operating characteristic (ROC) dataanalysis by a network of six South American laboratories. High intercenterreproducibility was attained, and the intralaboratory analysis allowed thecomparative ranking of the antigen panel. HCF, AgB, and its AgB8/1 subunitexhibited equivalent diagnostic efficiencies, 81.4% +/- 0.5%, 81.3% +/- 0.6%,and 81.9% +/- 2.0%, respectively; with a more favorable balance towardspecificity in the case of the last antigen. The diagnostic efficiencies for theother 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 alsoincluded an analysis of batch-to-batch variation in the diagnostic performanceof different HCF regional preparations. Based on these results, a suggestedrecommendation on the use of these antigens was drawn.