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评价 IgG 亲和力和 IgM 在参加先天性弓形虫病筛查计划的孕妇急性弓形虫病诊断中的不同截断值。

Evaluation of different cut-off points for IgG avidity and IgM in the diagnosis of acute toxoplasmosis in pregnant women participating in a congenital toxoplasmosis screening program.

机构信息

Secretaria de Estado de Saúde de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.

Universidade Federal de Minas Gerais, Instituto de Ciências Biológicas, Departamento de Parasitologia, Belo Horizonte, Minas Gerais, Brazil.

出版信息

Rev Inst Med Trop Sao Paulo. 2024 Jul 29;66:e43. doi: 10.1590/S1678-9946202466043. eCollection 2024.

Abstract

The main social impact of toxoplasmosis stems from its ability to be vertically transmitted. Postnatally acquired infection is generally asymptomatic in approximately 70-90% of cases, making diagnosis often dependent on laboratory tests using serological methods to search for anti-T. gondii antibodies. This study aimed to investigate the ability of the VIDAS TOXO IgG avidity and VIDAS TOXO IgM assays to confirm recent toxoplasmosis. In total, 341 pregnant women with suspected acute toxoplasmosis were systematically monitored in the Program for Control of Congenital Toxoplasmosis in Minas Gerais State, Brazil. We conducted an observational analytical-descriptive cross-sectional study and grouped according to clinical and laboratory criteria as having acute or chronic toxoplasmosis. The VIDAS TOXO IgG avidity and VIDAS TOXO IgM assays were evaluated to investigate the capacity to identify acute infection. IgG avidity showed good performance in identifying acute toxoplasmosis when the IgG avidity index was lower than or equal to 0.1. Values greater than or equal to 3.16 according to the TOXO IgM kit were associated with a greater chance of acute infection. These results may contribute to a more adequate diagnosis of acute gestational toxoplasmosis and, consequently, the avoidance of inadequate or unnecessary treatments.

摘要

弓形虫病的主要社会影响源于其垂直传播的能力。大约 70-90%的病例后天获得的感染通常无症状,因此诊断通常依赖于实验室检测,使用血清学方法来寻找抗弓形虫抗体。本研究旨在探讨 VIDAS TOXO IgG 亲和力和 VIDAS TOXO IgM 检测在确认近期弓形虫病方面的能力。在巴西米纳斯吉拉斯州先天性弓形虫病控制计划中,共有 341 名疑似急性弓形虫病的孕妇接受了系统性监测。我们进行了一项观察性分析性描述性的横断面研究,并根据临床和实验室标准分为急性或慢性弓形虫病。评估了 VIDAS TOXO IgG 亲和力和 VIDAS TOXO IgM 检测,以研究其识别急性感染的能力。当 IgG 亲和力指数低于或等于 0.1 时,IgG 亲和力显示出良好的识别急性弓形虫病的能力。根据 TOXO IgM 试剂盒,大于或等于 3.16 的值与急性感染的可能性更大相关。这些结果可能有助于更准确地诊断急性妊娠弓形虫病,并避免不适当或不必要的治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e06/11295287/f836dd2fc23d/1678-9946-rimtsp-66-S1678-9946202466043-gf01.jpg

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