Neurocysticercosis: HP10 Antigen Detection Is Useful for the Follow-up of the Severe Patients

Agnès Fleury,Esperanza Garcia,Tzipe Govezensky,R. Michael Evans Parkhouse,Leslie J. S. Harrison,Marisela Hernández,Edda Sciutto,Roger Carrillo,Gladis Fragoso,Stanny Geerts

doi:10.1371/journal.pntd.0002096

Abstract

BackgroundThe most severe clinical form of neurocysticercosis (NC) occurs when cysticerci are located in the subarachnoid space at the base of the brain (SaB). The diagnosis, monitoring and treatment of NC-SaB, constitutes a severe clinical challenge. Herein we evaluate the potential of the HP10 antigen detection enzyme-linked immunosorbent assay (HP10 Ag-ELISA) in the long term follow-up of NC-SaB cases. Assay performance was compared with that of Magnetic Resonance Imaging (MRI). In addition, the robustness of the HP10 Ag-ELISA was evaluated independently at two different institutions.Methodology/Principal FindingsA double-blind prospective cohort trial was conducted involving 38 NC-SaB cases and a total of 108 paired serum and cerebrospinal fluid (CSF) samples taken at intervals of 4 to 8 months for up to 43 months. At each medical visit, results of sera and CSF HP10 Ag-ELISA and MRI obtained at last visit were compared and their accuracy was evaluated retrospectively, considering radiological evolution between appointments. In the long-term follow-up study, HP10 Ag-ELISA had a better agreement than MRI with retrospective radiological evaluation. High reproducibility of HP10 Ag-ELISA between laboratories was also demonstrated.ConclusionsResults reported in this study establish for the first time the usefulness of the comparatively low cost HP10 Ag-ELISA for long term follow-up of NC-SaB patients.

Highlights

Neurocysticercosis (NC) is one of the most frequent parasitic diseases affecting the human central nervous system [1]
Reproducibility between institutions in assay performance Kappa analysis indicated a good to very good level of agreement between positive/negative allocations comparing results obtained in both institutions (CSF Kappa: 0.86 [0.75–0.97, P,0.0001] and serum Kappa: 0.76 [0.64–0.89, P,0.0001]) [15]
Cestodes such as T. solium, it is useful for NC diagnosis [11,12,13,14,15]

Summary

Introduction

Neurocysticercosis (NC) is one of the most frequent parasitic diseases affecting the human central nervous system [1]. It is transmitted by the ingestion of Taenia solium eggs mainly through the consumption of contaminated vegetables, and is still prevalent in most countries of Asia, Africa and Latin America, including Mexico [2]. The most severe clinical form of neurocysticercosis (NC) occurs when cysticerci are located in the subarachnoid space at the base of the brain (SaB). We evaluate the potential of the HP10 antigen detection enzyme-linked immunosorbent assay (HP10 Ag-ELISA) in the long term follow-up of NC-SaB cases. The robustness of the HP10 Ag-ELISA was evaluated independently at two different institutions

Methods

Results

Discussion

Conclusion