Pérez Floribeth León, Miss-Vivas Gloria, Hernández Virginia Peña, Monteon Victor
Universidad Autónoma Campeche, Facultad de Odontología, Campeche, Mexico.
Centro Estatal de Transfusión Sanguínea Campeche, Campeche, Mexico.
Rev Inst Med Trop Sao Paulo. 2025 Aug 25;67:e57. doi: 10.1590/S1678-9946202567057. eCollection 2025.
Trypanosoma cruzi can be transmitted by blood transfusion in non-endemic areas, and in endemic areas the risks may be higher. We investigated the seroprevalence of anti-T. cruzi antibodies in 1,500 blood donors from a blood bank in an endemic area where Triatoma dimidiata constitutes the main vector and in 2,800 healthy young subjects. Choosing antigens is crucial in diagnostic tests as it directly influences performance across regions. We screened 1,500 blood donors in parallel for chimeric Trypanosoma cruzi antigens with the ABBOTT PRISM Chagas assay at the State Blood Transfusion Center and with an in-house ELISA assay using local T. cruzi antigenic extracts at a Biomedical Research Center laboratory. Overall, 13 T. cruzi isolates from the Yucatan Peninsula, Mexico, were characterized for their antigenic profiles before being used in an in-house ELISAs. All T. cruzi isolates shared immunodominant antigens among themselves and with South American strains (particularly those below 100 kDa). Seroprevalence of anti-T. cruzi antibodies in blood donors totaled 0.2% (3/1500) in the ABBOTT PRISM Chagas assay and 0.26% (4/1500) in the in-house ELISA. We found low sensitivity (33%; 95%CI 0.01710 to 0.8815), high specificity (99.8%; 95%CI 0.9941 to 0.9995), and a low kappa index (0.2). Seroprevalence in young subjects totaled 0.14 %. We found comparable seroprevalence to blood banks in large Mexican municipalities free of vector transmission. Thus, optimal public immunodominant antigens are needed to cover the broad immune spectrum induced by T. cruzi infection.
克氏锥虫可通过输血在非流行地区传播，而在流行地区这种风险可能更高。我们调查了来自一个流行地区血库的1500名献血者以及2800名健康年轻受试者中抗克氏锥虫抗体的血清阳性率。在该流行地区，二点锥猎蝽是主要传播媒介。在诊断测试中选择抗原至关重要，因为它直接影响不同地区的检测性能。我们在州输血中心使用雅培PRISM查加斯检测法，同时在生物医学研究中心实验室使用本地克氏锥虫抗原提取物进行的内部酶联免疫吸附测定（ELISA），对1500名献血者进行了嵌合克氏锥虫抗原的平行筛查。总体而言，来自墨西哥尤卡坦半岛的13株克氏锥虫分离株在用于内部ELISA之前，对其抗原谱进行了表征。所有克氏锥虫分离株之间以及与南美菌株（特别是那些低于100 kDa的菌株）共享免疫显性抗原。在雅培PRISM查加斯检测法中，献血者中抗克氏锥虫抗体的血清阳性率总计为0.2%（3/1500），在内部ELISA中为0.26%（4/1500）。我们发现敏感性较低（33%；95%置信区间0.01710至0.8815），特异性较高（99.8%；95%置信区间0.9941至0.9995），kappa指数较低（0.2）。年轻受试者中的血清阳性率总计为0.14%。我们发现与墨西哥无媒介传播的大城市血库的血清阳性率相当。因此，需要最佳的公共免疫显性抗原以涵盖克氏锥虫感染诱导的广泛免疫谱。
