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IMMUNOLOGIC TESTS IN PATIENTS AFTER CLINICAL CURE OF VISCERAL LEISHMANIASIS

The results of five serologic tests (ELISA using promastigote antigen [ELISAp] and recombinant K39 [ELISArK39] and K26 [ELISArK26] antigens, indirect immunofluorescence test using promastigote antigen [IIFT], and immunochromatographic tests using the rK39 antigen [TRALd]) and of the Montenegro skin test (MST) were analyzed in 41 individuals treated for kala-azar and living in Porteirinha, Minas Gerais, Brazil. The tests were carried out 1 week to 12 years after specific treatment. All MSTs during the 8 months after treatment were negative, whereas after 1 year, 28 (84.8%) were positive. Negativity in all serologic tests was observed for 11 (26.8%) of the 41 individuals, whereas positivity in at least one test was observed for 70.3% of subjects evaluated 2 years after treatment. With respect to each exam, positivity was 38.0% for TRALd, 61.9% for ELISA rK39, 47.6% for ELISA rK26, 38.0% for ELISAp, and 40.5% for IIFT. None of the individuals presented recurrence of the disease during the 4 years of follow-up. The tests were repeated in 24 of the 41 individuals, after some time, and the results were the same in 33.3% of the cases. We conclude that serological tests for kala-azar might continue to be positive after treatment of the disease, although this does not indicate a poor prognosis or a poor therapeutic response.

Received November 15, 2005. Accepted for publication June 12, 2006.

Acknowledgments: The authors thank Dr. Antônio Campos-Neto for providing the rK39 and rK26 antigens, Prof. Roberto Badaró for providing the TRALd strips, and Prof. Wilson Mayrink for the MST antigen.

Financial support: The study was supported by the National Council for Scientific and Technological Development and the National Health Foundation.

^* Address correspondence to Aluízio Prata, Department of Tropical Medicine and Infectology, Federal University of Triângulo Mineiro, Brazil, Caixa Postal: 118, CEP 38001-970, Uberaba, MG, Brazil. E-mail: a_prata{at}mednet.com.br

Authors’ addresses: Luciana de Almeida Silva, Héctor Dardo Romero, Aluízio Prata, and Virmondes Rodrigues, Department of Tropical Medicine and Infectology, Federal University of Triângulo Mineiro, Caixa Postal: 118, CEP 38001-970, Uberaba, Brazil, Telephone: 34-3318-5254, Fax: 34-3318-5229. Roberto Teodoro Costa and Evaldo Nascimento, Laboratory of Leishmaniasis and Vaccines, Department of Parasitology, Institute of Biological Sciences, Federal University of Minas Gerais, Av. Antônio Carlos 6627, CEP 31270-901 Belo Horizonte, MG, Brazil. Sílvio Fernandes, Guimarães Carvalho Clemente Faria Hospital, States University of Montes Claros, Av. Cula Mangabeira 562, CEP 39401-002 Montes Claros, MG, Brazil.

Reprint requests: Aluízio Prata, Department of Tropical Medicine and Infectology, Federal University of Triângulo Mineiro, Brazil, Caixa Postal: 118, CEP 38001-970, Uberaba, MG, Brazil. E-mail: a_prata{at}mednet.com.br.

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