Document Detail


Reliability of immunoglobulin G antitoxoplasma avidity test and effects of treatment on avidity indexes of infants and pregnant women.
MedLine Citation:
PMID:  15242939     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The immunoglobulin G antitoxoplasma avidity test (Vidas; BioMérieux) is an immunoenzymatic test useful for excluding acute infection after the onset of pregnancy. The avidity index (AI) is the ratio of the signal in a test sample washed with urea, which disrupts low-avidity complexes, to that washed without urea. An AI of >0.3 is taken to mean that infection had occurred more than 4 months ago. The increase of the AI with time and the influence of the different treatments given to pregnant women and their newborns were evaluated. A total of 59 pregnant women (271 sera) and their 60 neonates (199 sera) were tested from 1998 to 2002. There were five groups of women based on the type and duration of treatment given. Thirteen pregnant women (group 1) did not receive any treatment, 15 (group 2), 11 (group 3), and 17 (group 4) women received treatment with spiramycin (9 MIU/day) for 0.5 to 2, 2.5 to 5, and 5.5 to 8 months, respectively, and the last 3 women (group 5) received tritherapy (pyrimethamine-sulfonamide and spiramycin alternatively) for 1.5 to 2.5 months. All of the maternal sera collected in the first 6 months had an AI of <0.30, with a mean of 0.07 (range, 0.01 to 0.21). The increase was slow (0.02/month), and there was no significant difference when comparisons were made between the treatment groups. Neonates with proven maternofetal transmission had an increasing AI, unlike those without transmission. However, long-term therapy with pyrimethamine-sulfonamide, as opposed to treatment with spiramycin alone, was found to slow down the progression of the AI. An AI of >0.2 is sufficient to exclude acute infection in pregnant women. In neonates, it is not of major use to diagnose congenital infection; however, it could be a good indicator of compliance and efficacy of treatment of infected infants.
Authors:
Pierre Flori; Laetitia Tardy; Hugues Patural; Bahrie Bellete; Marie-Noëlle Varlet; Jamal Hafid; Hélène Raberin; Roger Tran Manh Sung
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Clinical and diagnostic laboratory immunology     Volume:  11     ISSN:  1071-412X     ISO Abbreviation:  Clin. Diagn. Lab. Immunol.     Publication Date:  2004 Jul 
Date Detail:
Created Date:  2004-07-09     Completed Date:  2005-01-13     Revised Date:  2013-06-09    
Medline Journal Info:
Nlm Unique ID:  9421292     Medline TA:  Clin Diagn Lab Immunol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  669-74     Citation Subset:  IM    
Affiliation:
Laboratory of Parasitology and Mycology, Hôpital Nord, University Hospital of Saint Etienne, France. pierre.flori@univ-st-etienne.fr
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MeSH Terms
Descriptor/Qualifier:
Animals
Anti-Bacterial Agents / therapeutic use
Drug Therapy, Combination / therapeutic use
Female
Humans
Immunoenzyme Techniques*
Immunoglobulin G / blood*,  drug effects
Infant, Newborn
Pregnancy
Pregnancy Complications, Infectious / blood*,  immunology
Pyrimethamine / therapeutic use
Spiramycin / therapeutic use
Sulfonamides / therapeutic use
Time Factors
Toxoplasma / immunology
Toxoplasmosis / blood*,  diagnosis*,  drug therapy
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Immunoglobulin G; 0/Sulfonamides; 58-14-0/Pyrimethamine; 8025-81-8/Spiramycin
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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