Singh Sarman, Pandit Amol J
Division of Clinical Microbiology, All India Institute of Medical Sciences, New Delhi, India.
Am J Reprod Immunol. 2004 Oct;52(4):276-83. doi: 10.1111/j.1600-0897.2004.00222.x.
Toxoplasmosis is a major cause of congenitally acquired infections causing high degree of morbidity and mortality in the newborns.
IgG avidity method was used to distinguish the recent and more than 4 months old infection in a prospective cohort study for the first time in India. One hundred and eighty pregnant women presented in their first 4 months of pregnancy were included in this study. Their sera were tested for anti-Toxoplasma gondii antibodies using direct agglutination test, immunoglobulin (Ig)G and IgM-enzyme-linked immunosorbent assay, IgM-immunosorbent agglutination assay and VIDAS-IgG avidity.
Overall IgG seroprevalence rate of toxoplasmosis was 45%. Only seven women (3.3%) were found to have IgM antibodies and only two of these showed low IgG avidity indicating recent infection of <or=4 months duration. One woman aborted spontaneously at her fourth month of gestation. In remaining five women the recent infection could successfully be excluded by IgG avidity testing. All these women had uneventful pregnancy.
This study indicated that all IgM antibody positive pregnant must be tested for IgG avidity to rule out recent primary infection.
弓形虫病是先天性感染的主要原因,可导致新生儿出现高度的发病率和死亡率。
在印度的一项前瞻性队列研究中,首次使用IgG亲和力方法来区分近期感染和感染超过4个月的情况。本研究纳入了180名在怀孕前4个月就诊的孕妇。使用直接凝集试验、免疫球蛋白(Ig)G和IgM酶联免疫吸附测定、IgM免疫吸附凝集测定以及VIDAS-IgG亲和力检测对她们的血清进行抗弓形虫抗体检测。
弓形虫病的总体IgG血清阳性率为45%。仅发现7名女性(3.3%)有IgM抗体,其中只有2名显示低IgG亲和力,表明近期感染持续时间≤4个月。一名女性在妊娠第四个月自然流产。在其余五名女性中,通过IgG亲和力检测成功排除了近期感染。所有这些女性的妊娠过程均顺利。
本研究表明,所有IgM抗体阳性的孕妇都必须进行IgG亲和力检测,以排除近期原发性感染。