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Assessment of post-treatment disease activity among patients with cystic echinococcosis (CE) is insensitive using detection of CE-specific total IgG antibody. This study investigated whether serum concentrations of CE-specific IgG subclasses 1–4 correlate better with disease activity than total IgG. We studied a cohort of patients (n = 28) with symptomatic CE treated with anthelminthic drugs and surgery and who were followed up clinically and radiologically for a mean of 5.6 years (range = 3–12 years). Serial archived sera collected during follow-up were retrospectively analyzed by enzyme-linked immunosorbent assays using crude horse hydatid cyst fluid as antigen. Changes in concentrations of antibodies were correlated with clinical and radiologic outcome. At diagnosis, concentrations of CE-specific total IgG, IgG1, and IgG2 antibodies were significantly elevated in a greater proportion of patients compared with IgG3 and IgG4 antibodies. During post-treatment follow up, the IgG2 antibody response provided the best correlate of disease activity.
Received October 24, 2003. Accepted for publication December 1, 2003.
Acknowledgment: We are grateful for the administrative assistance provided by Margaret Armstrong.
Authors’ addresses: Stephen D. Lawn, Department of Infectious Diseases, St. George’s Hospital Medical School, London SW17 ORE, United Kingdom, Telephone: 44-208-725-5828, Fax: 44-208-725-3487, E-mail: stevelawn{at}yahoo.co.uk. John Bligh, Hospital for Tropical Diseases, London WC1E 6AU, United Kingdom. Philip S. Craig, Cestode Zoonoses Research Group, School of Environment and Life Sciences, University of Salford, Salford M5 4WT, United Kingdom. Peter L. Chiodini, Hospital for Tropical Diseases, London, United Kingdom and Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom.
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