He-Hua Hu, Xia Zhang, Chun-Bin Zhang, Yi-Bin Yao, Cai-Xia Cui, Xia Li, Xiao-Hong Wen, Jun Liu, Chuan-Yun Xiao, Xiong Liu, Chun-Li Cao
Jiangling County Institute of Schistosomiasis Control, Hubei Province, Jiangling 434100, China.
Co-first Author.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi. 2018 Jan 15;30(1):22-25. doi: 10.16250/j.32.1374.2017065.
To investigate the changes of serum anti-schistosome antibody titers in schistosomiasis japonica patients after treatment, in order to provide the evidence for formulating the schistosomiasis surveillance program in marshland and lake regions.
Upon prospective cohort study, the stool examination positive schistosomiasis patients and blood examination positive suspected patients (the titer was more than 1:80, including 1:80) were selected as the research objects in Jiangling County in 2014, and they received the 2-day praziquantel therapy. Half year, one year and two years after the treatment, their blood samples and fecal samples were collected for IHA anti-schistosome antibody detections and schistosome egg and miracidium detections.
In 2014, the stool examination positives were 251, and the majority of them were over 41 years old, accounting for 93.23% (234/251) ; 581 cases of high antibody titers were detected by the IHA method, and the majority of them were over 41 years old, accounting for 89.16% (518/581) . Half year, one year and two years after the treatment, among the stool examination positives, the negative conversion rates of stool positives were 99.60% (250/251), 100% (239/239) and 100% (234/234) respectively and the negative conversion rates of antibody positives were 21.91% (55/251), 64.11% (156/239) and 76.89% (193/234) respectively. In the high antibody titer positives, the negative conversion rates were 38.04% (221/581), 64.11% (359/560), and 77.86% (429/551) respectively, Half year, one year and two years after the treatment. There were statistically significant differences among the antibody negative conversion rates by test ( = 77.538, 183.412, 25.469 respectively, all < 0.001) . The geometric mean values of antibody titers of different durations between 2 groups were analyzed by 2-independent-samples test, and the geometric mean values of antibody titers between the 2 groups were different before the treatment ( = 23.576, < 0.01), but the geometric mean values of antibody titers between the 2 groups were not different 6 months, 1 year and 2 years after the treatment ( = -0.046, 1.165, -0.132, = 0.964, 0.245, 0.895 respectively).
The levels of serum anti-schistosome antibody degrade slowly in schistosomiasis japonica patients after the treatment, and the results of IHA tests cannot distinguish the current schistosome infection from previous schistosome infection. Therefore, it is necessary to develop the specific diagnostic technology for schistosome infection in order to meet the need of monitoring.
探讨日本血吸虫病患者治疗后血清抗血吸虫抗体滴度的变化，为制定沼泽和湖沼地区血吸虫病监测方案提供依据。
采用前瞻性队列研究，选取2014年江陵县粪便检查阳性的血吸虫病患者和血检阳性的疑似患者（滴度大于等于1:80）作为研究对象，给予吡喹酮2日疗法治疗。治疗后半年、1年和2年，采集其血样和粪便样本，进行间接血凝试验（IHA）检测抗血吸虫抗体以及血吸虫虫卵和毛蚴检测。
2014年粪便检查阳性者251例，其中41岁以上者居多，占93.23%（234/251）；IHA法检测出高抗体滴度者581例，其中41岁以上者居多，占89.16%（518/581）。治疗后半年、1年和2年，粪便检查阳性者中，粪便转阴率分别为99.60%（250/251）、100%（239/239）和100%（234/234），抗体转阴率分别为21.91%（55/251）、64.11%（156/239）和76.89%（193/234）。高抗体滴度阳性者中，治疗后半年、1年和2年的转阴率分别为38.04%（221/581）、64.11%（359/560）和77.86%（429/551）。治疗后半年、1年和2年抗体转阴率经检验差异有统计学意义（值分别为77.538、183.412、25.469，均P<0.001）。采用两独立样本检验分析两组不同病程抗体滴度的几何均值，治疗前两组抗体滴度几何均值不同（t=23.576，P<0.01），但治疗后6个月、1年和2年两组抗体滴度几何均值差异无统计学意义（t分别为-0.046、1.165、-0.132，P分别为0.964、0.245、0.895）。
日本血吸虫病患者治疗后血清抗血吸虫抗体水平下降缓慢，IHA检测结果无法区分现症血吸虫感染与既往血吸虫感染。因此，有必要研发血吸虫感染特异性诊断技术以满足监测需求。
