PERFORMANCE OF RECOMBINANT K39 ANTIGEN IN THE DIAGNOSIS OF BRAZILIAN VISCERAL LEISHMANIASIS

SILVIO F. GUIMARÃES CARVALHO Universidade Estadual de Montes Claros, Montes Claros, Minas Gerais, Brazil; Núcleo de Doenças Infecciosas, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil; Duke University Medical Center, Durham, North Carolina

Search for other papers by SILVIO F. GUIMARÃES CARVALHO in
Current site
Google Scholar
PubMed
Close
,
ELENICE MOREIRA LEMOS Universidade Estadual de Montes Claros, Montes Claros, Minas Gerais, Brazil; Núcleo de Doenças Infecciosas, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil; Duke University Medical Center, Durham, North Carolina

Search for other papers by ELENICE MOREIRA LEMOS in
Current site
Google Scholar
PubMed
Close
,
RALPH COREY Universidade Estadual de Montes Claros, Montes Claros, Minas Gerais, Brazil; Núcleo de Doenças Infecciosas, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil; Duke University Medical Center, Durham, North Carolina

Search for other papers by RALPH COREY in
Current site
Google Scholar
PubMed
Close
, and
REYNALDO DIETZE Universidade Estadual de Montes Claros, Montes Claros, Minas Gerais, Brazil; Núcleo de Doenças Infecciosas, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil; Duke University Medical Center, Durham, North Carolina

Search for other papers by REYNALDO DIETZE in
Current site
Google Scholar
PubMed
Close
Restricted access

This study evaluated the performance of recombinant K39 (rK39) antigen in a immunochromatographic format (strip test) and a crude antigen enzyme-linked immunosorbent assay in the diagnosis of Brazilian visceral leishmaniasis (VL) in 128 consecutive patients with parasitologically proven infections (by microscopy and/or culture). For each patient, a medical history was obtained and a complete physical examination was performed. Controls included 10 healthy volunteers and 50 patients with other diseases: malaria (10), leprosy (9), Chagas’ disease (10), tuberculosis (10), and cutaneous leishmaniasis (11). The sensitivities of the rK39 antigen strip test and the ELISA were 90% and 89%, respectively, while the specificities were 100% and 98%, respectively. Our study confirms the accuracy of the rK39 antigen strip test in the diagnosis of VL in a high prevalence population.

Author Notes

  • 1

    Desjeux P, 1996. Leishmaniasis. Public health aspects and control. Clin Dermatol 14 :417–423.

  • 2

    Pearson RD, de Queiroz SA, 1996. Clinical spectrum of leishmaniasis. Clin Infect Dis 22 :1–13.

  • 3

    Sundar S, More DK, Singh MK, Singh VP, Sharma S, Makharia A, Kumar PC, Murray HW, 2000. Failure of pentavalent antimony in visceral leishmaniasis in India. Report from the center of the Indian epidemic. Clin Infect Dis 31 :1104–1107.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4

    Zijlstra EE, Ali MS, El-Hassan AM, El-Toum IA, Satti M, Gjalib HW, Kager PA, 1992. Kala-zar: a comparative study of parasitological methods and the direct agglutination test in diagnosis. Trans R Soc Trop Med Hyg 86 :505–507.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5

    Scott JM, Shreffler WG, Ghalib HW, Asad A, Siddig M, Badaro R, Reed SG, 1991. A rapid and simple diagnostic test for active visceral leishmaniasis. Am J Trop Med Hyg 44 :272–277.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6

    Piarroux R, Gambarelli F, Dumon H, Fontes M, Dunan S, Mary C, Toga B, Quilici M, 1994. Comparison of PCR with direct examination of bone marrow aspiration, myeloculture, and serology for diagnosis of visceral Leishmaniasis in immunocompromised patients. J Clin Microbiol 32 :746–749.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7

    Badaró R, Benson D, Eulálio MC, Freire M, Cunha S, Netto EM, Pedral-Sampaio D, Madureira C, Burns JM, Houghton RL, David JR, Reed SG, 1996. A cloned antigen of L. chagasi that predicts active visceral leishmaniasis (VL). J Infect Dis 173 :758–761.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8

    Zijlstra E, Daifalla N, Kager P, Khalil E, El-Hassan, Reed S, Ghalib H, 1998. K39 enzyme-linked immunosorbent assay for diagnosis of Leishmania donovani infection. Clin Diagn Lab Immunol 5 :717–720.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9

    Burns JM Jr, Shreffler WG, Benson DR, Ghalib HW, Badaro′ R, Reed SG, 1993. Molecular characterization of a kinesin-related antigen of Leishmania chagasi that detects antibody in African and American visceral leishmaniasis. Proc Nat Acad Sci USA 90 :775–779.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10

    Bradford MM, 1976. A rapid and sensitive method for quantification of microgram quantities of protein utilizing the principle of protein-dye binding. Anal Biochem 77 :248–254.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11

    Sundar S, Reed S, Singh V, Kumar P, Murray H, 1998. Rapid accurate field diagnosis of Indian visceral leishmaniasis. Lancet 351 :563–565.

  • 12

    Sundar S, Pai K, Sahu M, Kumar V, Murray, HW, 2002. Immunochromatographic strip-test detection of anti-K39 antibody in Indian visceral leishmaniasis. Ann Trop Med Parasitol 96 :19–23.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13

    Bern C, Jha SN, Joshi AB, Thakur GD, Bista MB, 2000. Use of the recombinant K39 dipstick test and the direct agglutination test in a setting endemic for visceral leishmaniasis in Nepal. Am J Trop Med Hyg 63 :153–157.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14

    Delgado O, Feliciangeli MD, Coraspe V, Silva S, Perez A, Arias J, 2001. Value of a dipstick based on recombinant rK39 antigen for differential diagnosis of American visceral leishmaniasis from other sympatric endemic diseases in Venezuela. Parasite 8 :355–357.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15

    Zijlstra E, Nur Y, Desjeux P, Khalil E, El-Hassan A, Groen J, 2001. Diagnosing visceral leishmaniasis with the recombinant K39 strip test: experience from the Sudan. Trop Med Int Health 6 :108–113.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16

    Jelinek T, Eichenlaub S, Losher T, 1999. Sensitivity and specificity of a rapid immunochromatographic test for diagnosis of visceral leishmaniasis. Eur J Clin Microbiol Infect Dis 18 :669–670.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17

    Dietze R, Barros GB, Teixeira L, Harris J, Michelson K, Falqueto A, Corey R, 1997. Effect of eliminating seropositive canines on the transmission of visceral leishmaniasis in Brazil. Clin Infect Dis 25 :1240–1242.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18

    Pintado V, Lopez-Velez R, 2001. HIV-associated visceral leishmaniasis. Clin Microbiol Infect 7 :291–300.

  • 19

    Houghton R, Petrescu M, Benson D, Skeiky Y, Scalone A, Badaro R, Reed S, Gradoni L, 1998. A cloned antigen (recombinant K39) of Leishmania chagasi diagnostic for visceral leishmaniasis in human immunodeficiency virus type I patients and a prognostic indicator for monitoring patients undergoing drug therapy. J Infect Dis 177 :1339–1344.

    • PubMed
    • Search Google Scholar
    • Export Citation
Past two years Past Year Past 30 Days
Abstract Views 257 186 10
Full Text Views 483 2 0
PDF Downloads 104 2 0
 
 
 
 
Affiliate Membership Banner
 
 
Research for Health Information Banner
 
 
CLOCKSS
 
 
 
Society Publishers Coalition Banner
Save