Serological confirmatory testing of alveolar and cystic echinococcosis in clinical practice: results of a comparative study with commercialized and in-house assays

Clin Lab. 2009;55(1-2):41-8.

Abstract

Sera of 50 patients with either cystic (CE) or alveolar echinococcosis (AE) in different clinical stages were examined for the presence of anti-Echinococcus-antibodies. Antibody-screening was performed with ELISA, IHA and IFAT, and confirmatory testing was done by the commercialized E. multilocularis-specific Em2plus-ELISA versus an in-house E. multilocularis-specific Em10-ELISA. Sera with discrepant confirmatory results were subjected to a commercial Echinococcus IgG Western blot (WB). In sera from patients with CE, the Em2plus-ELISA showed cross-reactions in 23.5%, whereas the Em10-ELISA did not exhibit any cross-reactivity. Cross-reactivity paralleled active infection with high antibody titers in the screening assays. In sera from patients with AE, confirmation by both ELISAs was achieved in 57.6%, mostly in patients with an advanced stage of the disease and high antibody titers in the screening assays. False-negative reactions of both ELISAs occurred in 30.3%, mostly in patients who had low antibody levels in the screening tests. The Em2plus-ELISA exhibited fewer false-negative reactions than the Em10-ELISA. The WB confirmed the positive results of either assay and was the assay with the highest reliability at different stages of CE and AE, followed by the Em2plus-ELISA for AE. High antibody titers in the screening assays will favour the detection of species-specific antibodies in either form.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Animals
  • Antibodies, Helminth / blood*
  • Blotting, Western
  • Cross Reactions
  • Echinococcosis / diagnosis*
  • Echinococcosis / immunology
  • Echinococcosis, Pulmonary / diagnosis*
  • Echinococcosis, Pulmonary / immunology
  • Echinococcus / immunology*
  • Enzyme-Linked Immunosorbent Assay
  • False Negative Reactions
  • Female
  • Fluorescent Antibody Technique
  • Hemagglutination Tests
  • Humans
  • Male
  • Middle Aged
  • Reagent Kits, Diagnostic
  • Serologic Tests / methods*
  • Species Specificity

Substances

  • Antibodies, Helminth
  • Reagent Kits, Diagnostic