Abstract
The efficiency of chlamydia-specific secretory IgA antibodies as determined by ELISA in diluted tear samples, and of serum IgG and IgA by both immunoperoxidase (IPA) and ELISA was compared to culture of C. trachomatis for the diagnosis of paratrachoma in patients with conjunctivitis. Compared with isolation, ELISA determination of chlamydia-specific secretory IgA had a specificity and efficiency of 93% and 87%, respectively, a sensitivity of 62% and a positive predictive value of 67%. Immunoperoxidase determination of chlamydia serum IgA (titer≥8) and serum IgG antibodies at high titer (≥128) had specificities and efficiencies of 86% and 81% for IgA and 82% and 77% for IgG, respectively. Similar results were obtained for serum IgG and IgA antibodies as detected by ELISA. Chlamydia-specific secretory IgA could not be detected in follow-up tear samples available 1–9 months after treatment, while serum IgA became undetectable in some of the patients. Determination of local secretory IgA and serum IgG and IgA specific to chalamydia may be complementary to culture in diagnosis of ocular paratrachoma infections.
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