Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.
Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen 40002, Thailand.
Trans R Soc Trop Med Hyg. 2020 Oct 5;114(10):751-761. doi: 10.1093/trstmh/traa057.
A urine antigen assay was applied to evaluate chemotherapeutic outcomes and reinfection patterns of opisthorchiasis in Thailand.
We used a prospective study design by following opisthorchiasis subjects at baseline and post-treatment using a urine antigen assay and faecal examination by the formalin-ethyl acetate concentration technique (FECT).
The antigen of Opisthorchis viverrini in urine diminished within 4 weeks after praziquantel treatment. Concurrent faecal examinations by FECT showed that faecal eggs were negative at 4 weeks after treatment. In a subsequent study, reinfection rates and intensity patterns of O. viverrini were evaluated at 48 weeks after praziquantel treatment. Within a group of subjects with curative treatment (n=137), 16.8% became reinfected according to FECT and 27.7% according to the urine antigen assay (p<0.05). There were significant correlations in intensity of infection between pretreatment and at 48 weeks post-treatment in both faecal egg counts and antigen levels in urine.
The results suggested that in addition to screening, the urine antigen assay is an efficient tool for monitoring outcomes of drug treatment and reinfection in opisthorchiasis. Due to the ease of urine sample collection and handling, the urine assay becomes an alternative method to faecal examination for diagnosis and monitoring of opisthorchiasis.
尿液抗原检测法已被应用于评估在泰国的华支睾吸虫病的化疗结果和再感染模式。
我们采用前瞻性研究设计，在基线时和治疗后使用尿液抗原检测法和粪便检查（使用甲醛-乙醚沉淀集卵法）来随访华支睾吸虫病患者。
在吡喹酮治疗后 4 周内，华支睾吸虫尿液抗原消失。同时进行的粪便检查（使用甲醛-乙醚沉淀集卵法）显示，治疗后 4 周粪便虫卵呈阴性。在随后的研究中，我们评估了吡喹酮治疗后 48 周的华支睾吸虫再感染率和感染强度模式。在治愈治疗组（n=137）中，根据粪便检查（使用甲醛-乙醚沉淀集卵法）有 16.8%的患者出现再感染，根据尿液抗原检测法有 27.7%的患者出现再感染（p<0.05）。在粪便虫卵计数和尿液抗原水平方面，治疗前和治疗后 48 周之间的感染强度均存在显著相关性。
这些结果表明，尿液抗原检测法除了可用于筛查，还可作为一种有效的工具，用于监测药物治疗的结果和华支睾吸虫病的再感染。由于尿液样本的采集和处理较为简便，该检测法成为了粪便检查的替代方法，可用于华支睾吸虫病的诊断和监测。
