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先天性感染克氏锥虫的新生儿应用苯硝唑治疗后抗体滴度下降。

Antibody drop in newborns congenitally infected by Trypanosoma cruzi treated with benznidazole.

机构信息

IRD UR010, Team Mother's and Child's Health in Tropical Environment, Institut de Recherche pour le Développement, La Paz, Bolivia.

出版信息

Trop Med Int Health. 2010 Jan;15(1):87-93. doi: 10.1111/j.1365-3156.2009.02431.x. Epub 2009 Nov 23.

Abstract

OBJECTIVE

To compare the drop of Chagas antibody titres between non-infected and congenitally infected newborns treated by two doses of benznidazole, aiming at evaluating the recovery time and giving recommendations regarding serological criteria of recovery.

METHODS

During a clinical trial, the drop of Trypanosoma cruzi antibody titres measured by ELISA tests was followed during the first year of life in congenitally infected newborns treated with different doses of benznidazole and compared to T. cruzi antibody titres in non-parasitaemic newborns. Confirmation of recovery was given by two negative serological tests: Chagas Stat-Pak (CSP) (immunochromatography) and Chagatest v3.0 (ELISA).

RESULTS

In non-parasitaemic infants of infected mothers, antibodies of maternal origin disappeared in <8 months while in infected infants, T. cruzi antibodies decreased more slowly and disappeared in 9-16 months allowing to confirm the recovery. All CSP tests were negative before the ninth month while about 10% of ELISA tests remained positive at the 12th month.

CONCLUSIONS

Recovery may be confirmed in most cases at 10 months. The CSP test was compared to Chagatest v3.0 ELISA and appeared to give a reliable response. The decrease rate of antibodies does not depend on treatment modes.

摘要

目的

比较经两剂苯达唑治疗的未感染和先天性感染新生儿之间的恰加斯抗体滴度下降情况,旨在评估恢复时间,并就恢复的血清学标准提出建议。

方法

在一项临床试验中,通过 ELISA 试验检测的克氏锥虫抗体滴度在接受不同剂量苯达唑治疗的先天性感染新生儿生命的第一年期间进行了随访,并与未寄生虫新生儿的克氏锥虫抗体滴度进行了比较。通过两次阴性血清学检测(Chagas Stat-Pak [CSP](免疫层析法)和 Chagatest v3.0(ELISA))来确认恢复。

结果

在感染母亲的非寄生虫婴儿中,来自母体的抗体在<8 个月内消失,而在感染婴儿中,克氏锥虫抗体下降较慢,在 9-16 个月内消失,从而确认了恢复。所有 CSP 检测在第 9 个月前均为阴性,而约 10%的 ELISA 检测在第 12 个月仍为阳性。

结论

在大多数情况下,10 个月即可确认恢复。CSP 检测与 Chagatest v3.0 ELISA 进行了比较,结果似乎很可靠。抗体的下降率与治疗方式无关。

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